Provider Demographics
NPI:1700201001
Name:SAUL, KATI (LCSW)
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:
Last Name:SAUL
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 1:4975 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5043
Mailing Address - Country:US
Mailing Address - Phone:719-419-3939
Mailing Address - Fax:719-419-3939
Practice Address - Street 1:4975 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5043
Practice Address - Country:US
Practice Address - Phone:719-419-3939
Practice Address - Fax:719-419-3939
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-23
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010932251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000165203Medicaid