Provider Demographics
NPI:1356621627
Name:BENES, KATHRYN MARGARET (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MARGARET
Last Name:BENES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:MARGARET
Other - Last Name:TRENTHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:4045 PECOS STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2552
Mailing Address - Country:US
Mailing Address - Phone:720-377-1359
Mailing Address - Fax:303-742-1181
Practice Address - Street 1:4045 PECOS STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2552
Practice Address - Country:US
Practice Address - Phone:720-377-1359
Practice Address - Fax:303-742-1181
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3535103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist