Provider Demographics
NPI:1144493198
Name:KERRIGAN, CATHERINE MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARIE
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CATHY
Other - Middle Name:MARIE
Other - Last Name:KERRIGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:559 VINCENT ST.
Mailing Address - Street 2:ATTN: 21 MDOS/SGOH - MENTAL HEALTH
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-8943
Mailing Address - Fax:866-867-7926
Practice Address - Street 1:559 VINCENT ST.
Practice Address - Street 2:ATTN: 21 MDOS/SGOH - MENTAL HEALTH
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-8943
Practice Address - Fax:866-867-7926
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical