Provider Demographics
NPI:1932846557
Name:BOSCHMANN, KATRINA LYNNE (LPCC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:LYNNE
Last Name:BOSCHMANN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:AULT
Mailing Address - State:CO
Mailing Address - Zip Code:80610-0201
Mailing Address - Country:US
Mailing Address - Phone:970-719-0292
Mailing Address - Fax:
Practice Address - Street 1:213 B ST
Practice Address - Street 2:
Practice Address - City:AULT
Practice Address - State:CO
Practice Address - Zip Code:80610-5045
Practice Address - Country:US
Practice Address - Phone:970-719-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019208101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional