Provider Demographics
NPI:1598236234
Name:HUBBARD, ERICA KATZ (LSW, NLC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:KATZ
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LSW, NLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 FINDLAY LN
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2157
Mailing Address - Country:US
Mailing Address - Phone:720-324-0607
Mailing Address - Fax:
Practice Address - Street 1:2002 W 120TH AVE STE A
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2434
Practice Address - Country:US
Practice Address - Phone:970-633-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0109155101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health