Provider Demographics
NPI:1942936836
Name:WANNER, KATHRYN (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WANNER
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5667 S URBAN ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-5236
Mailing Address - Country:US
Mailing Address - Phone:401-236-7455
Mailing Address - Fax:
Practice Address - Street 1:5890 S ALKIRE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-1421
Practice Address - Country:US
Practice Address - Phone:401-236-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018588101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health