Individual
KATE ELLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5412 IDYLWILD TRL, BOULDER, CO 80301
(720) 310-5125
Mailing address
5412 IDYLWILD TRL, BOULDER, CO 80301-3523
(720) 310-5125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
992554
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
992554
LCSW
CO
Enumeration date
12/14/2011
Last updated
08/05/2018
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