Provider Demographics
NPI:1689461089
Name:MACKENZIE, KATHERINE PAIGE (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PAIGE
Last Name:MACKENZIE
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8594
Mailing Address - Country:US
Mailing Address - Phone:415-450-0329
Mailing Address - Fax:
Practice Address - Street 1:736 MAIN AVE
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5541
Practice Address - Country:US
Practice Address - Phone:415-450-0329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional