Provider Demographics
NPI:1922826312
Name:KLINE, KATRINA (LSW)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:KLINE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GOLDEN CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3606
Mailing Address - Country:US
Mailing Address - Phone:612-600-6799
Mailing Address - Fax:
Practice Address - Street 1:4380 S SYRACUSE ST STE 320
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2420
Practice Address - Country:US
Practice Address - Phone:720-526-8102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099256681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical