Provider Demographics
NPI:1609426469
Name:SUMMER, CATHY (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:SUMMER
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 1:350 PONCA PLACE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303
Mailing Address - Country:US
Mailing Address - Phone:303-938-1110
Mailing Address - Fax:303-938-1145
Practice Address - Street 1:350 PONCA PLACE
Practice Address - Street 2:SUITE 250
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-3875
Practice Address - Country:US
Practice Address - Phone:303-938-1110
Practice Address - Fax:303-938-1145
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099239591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical