Provider Demographics
NPI:1548908965
Name:LANDSBAUM, KATHERYN ELIZABETH (LPCC)
Entity type:Individual
Prefix:MISS
First Name:KATHERYN
Middle Name:ELIZABETH
Last Name:LANDSBAUM
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10327 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2003
Mailing Address - Country:US
Mailing Address - Phone:720-314-8841
Mailing Address - Fax:
Practice Address - Street 1:10327 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2003
Practice Address - Country:US
Practice Address - Phone:720-314-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019586101YM0800X
COACD.0002275101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health