Provider Demographics
NPI:1033450762
Name:BRINK, KRISTEN (MSC MFCT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:MSC MFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S BLACKHAWK ST
Mailing Address - Street 2:210
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1487
Mailing Address - Country:US
Mailing Address - Phone:303-933-3910
Mailing Address - Fax:
Practice Address - Street 1:2121 S BLACKHAWK ST
Practice Address - Street 2:210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1487
Practice Address - Country:US
Practice Address - Phone:303-933-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0103552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health