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Organization

KATIE'S WAY COLORADO SPRINGS, PLLC

Active
Other names
KATIES WAY
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY RAE JOHNSON (CREDENTIALING DIRECTOR)
(785) 320-6616
Entity
Organization

Contact information

Practice address
630 SOUTHPOINTE CT STE 105, COLORADO SPRINGS, CO 80906-3800
(719) 249-8638
(719) 249-8592
Mailing address
720 POYNTZ AVE, MANHATTAN, KS 66502-6355
(785) 320-6616
(785) 706-5491

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103G00000X
Clinical Neuropsychologist
103T00000X
Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TP0814X
Psychoanalysis Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
202D00000X
Integrative Medicine Physician
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
2084P0015X
Psychosomatic Medicine Physician
2084P0800X
Psychiatry Physician
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
12/27/2022
Last updated
11/20/2024
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