Provider Demographics
NPI:1871324947
Name:CHAMPLIN RICE, LPC, KATHERINE (MA, LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CHAMPLIN RICE, LPC
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 TERRY ST STE 320
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5490
Mailing Address - Country:US
Mailing Address - Phone:970-235-0301
Mailing Address - Fax:
Practice Address - Street 1:350 TERRY ST STE 320
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5490
Practice Address - Country:US
Practice Address - Phone:970-235-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3773101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional