Provider Demographics
NPI:1447897384
Name:GOMES, KATHRYN NOEL (MA, LPC, NCC, LAC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:NOEL
Last Name:GOMES
Suffix:
Gender:F
Credentials:MA, LPC, NCC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 E TUFTS AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILLS VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80113-5928
Mailing Address - Country:US
Mailing Address - Phone:303-788-7350
Mailing Address - Fax:303-762-0476
Practice Address - Street 1:885 E TUFTS AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILLS VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80113-5928
Practice Address - Country:US
Practice Address - Phone:303-788-7350
Practice Address - Fax:303-762-0476
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0964101YA0400X
CO6036101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)