Provider Demographics
NPI:1902519408
Name:WOLFE, KATHERINE RENEE (MA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RENEE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 RED ROCKS VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-3008
Mailing Address - Country:US
Mailing Address - Phone:720-220-4344
Mailing Address - Fax:
Practice Address - Street 1:3333 S WADSWORTH BLVD UNIT D201
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5141
Practice Address - Country:US
Practice Address - Phone:720-220-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health