Provider Demographics
NPI:1700910734
Name:NELSON, CATHERINE (CAS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:SABINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAS
Mailing Address - Street 1:4247 E EASTER PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2250
Mailing Address - Country:US
Mailing Address - Phone:707-494-1032
Mailing Address - Fax:
Practice Address - Street 1:421 ZANG ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1052
Practice Address - Country:US
Practice Address - Phone:303-438-5784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
COACC.0998361101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)