Provider Demographics
NPI:1922075092
Name:CARGILL-HITCHCOCK, KERRIE C (LCSW)
Entity Type:Individual
Prefix:
First Name:KERRIE
Middle Name:C
Last Name:CARGILL-HITCHCOCK
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 1:375 NANCY CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3672
Mailing Address - Country:US
Mailing Address - Phone:970-203-0957
Mailing Address - Fax:
Practice Address - Street 1:1045 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3926
Practice Address - Country:US
Practice Address - Phone:970-493-6667
Practice Address - Fax:970-493-8016
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9919481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical