Provider Demographics
NPI:1619318227
Name:FERRELL, KATHERINE WALSH (LSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:WALSH
Last Name:FERRELL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:WALSH
Other - Last Name:FLAHERTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:3384 CRIPPLE CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-7151
Mailing Address - Country:US
Mailing Address - Phone:215-380-1519
Mailing Address - Fax:
Practice Address - Street 1:4455 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2415
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009920024101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health