Provider Demographics
NPI:1104249010
Name:KORENKE, KATHERINE (MS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KORENKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KAT
Other - Middle Name:E
Other - Last Name:KORENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1630 CARR ST
Mailing Address - Street 2:STE B
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5985
Mailing Address - Country:US
Mailing Address - Phone:720-260-8490
Mailing Address - Fax:720-260-8490
Practice Address - Street 1:1630 CARR ST
Practice Address - Street 2:STE B
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5985
Practice Address - Country:US
Practice Address - Phone:720-260-8490
Practice Address - Fax:720-260-8490
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist