Provider Demographics
NPI:1821313099
Name:CHABIN, KATHLEEN L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:L
Last Name:CHABIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 E PRENTICE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2707
Mailing Address - Country:US
Mailing Address - Phone:303-770-1214
Mailing Address - Fax:303-770-6501
Practice Address - Street 1:7995 E PRENTICE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2707
Practice Address - Country:US
Practice Address - Phone:303-770-1214
Practice Address - Fax:303-770-6501
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical