Provider Demographics
NPI:1659966562
Name:ADAMS, KATHLEEN (LPC, PTR)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC, PTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 YOUNGFIELD ST # 411
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5245
Mailing Address - Country:US
Mailing Address - Phone:303-587-9129
Mailing Address - Fax:
Practice Address - Street 1:15234 W 63RD AVE APT 102
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80403-7621
Practice Address - Country:US
Practice Address - Phone:303-587-9129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional