Provider Demographics
NPI:1033918255
Name:WEIMANN, KATHRYN TYRRELL (LSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TYRRELL
Last Name:WEIMANN
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 1:14762 STONEY CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8794
Mailing Address - Country:US
Mailing Address - Phone:708-834-4900
Mailing Address - Fax:
Practice Address - Street 1:14762 STONEY CREEK WAY
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-8794
Practice Address - Country:US
Practice Address - Phone:708-834-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009924512104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker