Provider Demographics
NPI:1568848141
Name:MINDENHALL, KATHARINE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:MINDENHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 WADSWORTH BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4542
Mailing Address - Country:US
Mailing Address - Phone:720-443-1947
Mailing Address - Fax:
Practice Address - Street 1:950 WADSWORTH BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4542
Practice Address - Country:US
Practice Address - Phone:720-443-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical