Provider Demographics
NPI:1689422719
Name:PASQUALETTO, KATIE (LPC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:PASQUALETTO
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 1:402 E SAN RAFAEL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2464
Mailing Address - Country:US
Mailing Address - Phone:909-816-4107
Mailing Address - Fax:
Practice Address - Street 1:402 E SAN RAFAEL ST APT 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2464
Practice Address - Country:US
Practice Address - Phone:909-816-4107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0020680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional