Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katie Hersom, MA

Individual provider Mental Health Counselor · NPI 1043075161

Katie Hersom, MA is a Mental Health Counselor in Arvada, Colorado. Qualified in 2020, 6 years ago. Practices with Samantha Ivy LLC, a 12-clinician group and offers telehealth. Licensed in Colorado.

Years since qualifying
6
Licensed in
CO
In the registry since
2024
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

6863 Johnson St
Arvada, CO 80004-2948
Phone: (720) 443-3934
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC.0020286 (CO)

Record details

NPI number1043075161
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA
Sole proprietorYes
NPI enumeratedFebruary 19, 2024
Last updated in NPPESMarch 13, 2024
Certification dateMarch 13, 2024
Mailing address6062 Estes St, Arvada, CO 80004-5444

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Samantha Ivy Llc — 12 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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