Provider Demographics
NPI:1073962429
Name:NATHAN, KRISTIN (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:NATHAN
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 1:1235 N LOGAN ST.
Mailing Address - Street 2:APT. 302
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2464
Mailing Address - Country:US
Mailing Address - Phone:720-585-5110
Mailing Address - Fax:
Practice Address - Street 1:2401 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5811
Practice Address - Country:US
Practice Address - Phone:720-213-6180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012993101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional