Provider Demographics
NPI:1982114997
Name:HENRICKS, CATHERINE ANN (MS, LAC, LCDC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:HENRICKS
Suffix:
Gender:F
Credentials:MS, LAC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 E DRY CREEK RD UNIT 5-202
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1651
Mailing Address - Country:US
Mailing Address - Phone:720-908-0911
Mailing Address - Fax:
Practice Address - Street 1:10200 E DRY CREEK RD UNIT 5-202
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-1651
Practice Address - Country:US
Practice Address - Phone:720-908-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000909101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty