Provider Demographics
NPI:1992522502
Name:VOLATILE, MARY KATHERINE (LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:VOLATILE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 EDWARDS ACCESS RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-5634
Mailing Address - Country:US
Mailing Address - Phone:970-445-2489
Mailing Address - Fax:
Practice Address - Street 1:439 EDWARDS ACCESS RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5634
Practice Address - Country:US
Practice Address - Phone:970-445-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0021192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional