Provider Demographics
NPI:1629346671
Name:LORCH, KATHLEEN RUTH (MS)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:RUTH
Last Name:LORCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:RUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 8974
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-9029
Mailing Address - Country:US
Mailing Address - Phone:970-398-2051
Mailing Address - Fax:
Practice Address - Street 1:619 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-389-2051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0011815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC.0011815OtherDORA