Provider Demographics
NPI:1982410296
Name:DESPONETT, CATHERINE (MA, MFTC, LAC, PRE)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:DESPONETT
Suffix:
Gender:
Credentials:MA, MFTC, LAC, PRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 32ND TRL
Mailing Address - Street 2:
Mailing Address - City:COTOPAXI
Mailing Address - State:CO
Mailing Address - Zip Code:81223-7809
Mailing Address - Country:US
Mailing Address - Phone:719-285-9772
Mailing Address - Fax:
Practice Address - Street 1:1363 32ND TRL
Practice Address - Street 2:
Practice Address - City:COTOPAXI
Practice Address - State:CO
Practice Address - Zip Code:81223-7809
Practice Address - Country:US
Practice Address - Phone:719-285-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002417101YA0400X
COMFT.0002794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)