Provider Demographics
NPI:1578578274
Name:AGUIRRE, KATHY A (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:A
Last Name:AGUIRRE
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 1:2224 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3749
Mailing Address - Country:US
Mailing Address - Phone:303-337-6664
Mailing Address - Fax:
Practice Address - Street 1:2101 S BLACKHAWK ST
Practice Address - Street 2:SUITE 250
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1492
Practice Address - Country:US
Practice Address - Phone:303-337-6664
Practice Address - Fax:303-696-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9820301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC87986Medicare ID - Type Unspecified
COR19929Medicare UPIN