Provider Demographics
NPI:1174934061
Name:PRUITT, KATHERINE M (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:PRUITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 E LOWRY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6082
Mailing Address - Country:US
Mailing Address - Phone:303-825-8589
Mailing Address - Fax:720-214-4609
Practice Address - Street 1:7900 E 1ST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7204
Practice Address - Country:US
Practice Address - Phone:303-731-8926
Practice Address - Fax:303-367-2576
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional