Provider Demographics
NPI:1487265484
Name:PUCCI, KATELYNN DWYER (MA, LPC, LCAT)
Entity type:Individual
Prefix:
First Name:KATELYNN
Middle Name:DWYER
Last Name:PUCCI
Suffix:
Gender:F
Credentials:MA, LPC, LCAT
Other - Prefix:
Other - First Name:KATELYNN
Other - Middle Name:
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 S MONACO ST APT 1111
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3454
Mailing Address - Country:US
Mailing Address - Phone:516-592-7337
Mailing Address - Fax:
Practice Address - Street 1:5585 ERINDALE DR STE 204
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6969
Practice Address - Country:US
Practice Address - Phone:719-345-2424
Practice Address - Fax:855-719-2549
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0022149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty