Basic Information
| Provider Information | |||||||||
| NPI: | 1306043153 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EIKE | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | LCSW, MSW | ||||||||
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| OtherLastName: | EIKE | ||||||||
| OtherFirstName: | CASEY | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4856 INNOVATION DR STE B | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805255540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704944200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1950 REDTAIL HAWK DR | ||||||||
| Address2: | |||||||||
| City: | ESTES PARK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805179780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704944200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2007 | ||||||||
| LastUpdateDate: | 05/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 9444 | FL | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 3725 | KS | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | CSW.09925069 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.