Provider Demographics
NPI:1053426130
Name:DUFF, KATHERINE SHELDON (LPC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:SHELDON
Last Name:DUFF
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:HC 78 BOX 9125
Mailing Address - Street 2:
Mailing Address - City:RANCHOS DE TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87557-9786
Mailing Address - Country:US
Mailing Address - Phone:505-779-0005
Mailing Address - Fax:505-737-5507
Practice Address - Street 1:1337 GUSDORF RD
Practice Address - Street 2:SUITE H
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6294
Practice Address - Country:US
Practice Address - Phone:505-779-0005
Practice Address - Fax:505-737-5507
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health