Individual ProviderKathleen J VandenbergSocial WorkerBehavioral Health & Social Service ProvidersPractice Address305 Carpenter Rd, Fort Collins, CO 80525-4248(970) 663-3500PECOS EnrollmentBased on the most recent information from CMS, provider Kathleen J Vandenberg does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1790032589Provider TypeIndividualFull NameVandenberg, Kathleen JGenderFemaleSole ProprietorNoEnumeration Date8/10/2012Last Updated6/23/2021Contact InformationPractice LocationPractice Address305 Carpenter Rd, Fort Collins, CO 80525-4248Phone(970) 663-3500Fax(970) 292-0898Mailing LocationMailing Address305 Carpenter Rd, Fort Collins, CO 80525-4248Phone(970) 663-3500Fax(970) 292-0898Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense2088ColoradoProvider IdentifiersIDDescriptionIssuerIDNONEDescriptionOtherIssuerNONEColorado