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Individual

KATIE CARROCCIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, LAC, EMDR

Contact information

Practice address
9139 RIDGELINE BLVD, HIGHLANDS RANCH, CO 80129-2333
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
LPC.0012138
CO
103TC0700X
Clinical Psychologist
LPC.00012138
CO
172V00000X
Community Health Worker
30-0135461
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
624855
CO
Enumeration date
09/04/2014
Last updated
05/19/2021
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