Provider Demographics
NPI:1043696958
Name:ISAACS, KRIS (MA, CACII)
Entity Type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:ISAACS
Suffix:
Gender:M
Credentials:MA, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E CANNON ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2207
Mailing Address - Country:US
Mailing Address - Phone:303-668-3943
Mailing Address - Fax:
Practice Address - Street 1:404 E CANNON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2207
Practice Address - Country:US
Practice Address - Phone:303-668-3943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10984101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor