Provider Demographics
NPI:1750197778
Name:HENDRICK, KATHERINE (MFTC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:HENDRICK
Suffix:
Gender:F
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1332
Mailing Address - Country:US
Mailing Address - Phone:303-642-5390
Mailing Address - Fax:
Practice Address - Street 1:1212 BOOKCLIFF AVE STE 3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8161
Practice Address - Country:US
Practice Address - Phone:970-697-4169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0014556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist