Provider Demographics
NPI:1083816730
Name:GEARHART, KRISTIN N (LPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:N
Last Name:GEARHART
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 1:1250 S PARKER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2178
Mailing Address - Country:US
Mailing Address - Phone:303-641-7617
Mailing Address - Fax:866-688-8087
Practice Address - Street 1:2864 S CIRCLE DR
Practice Address - Street 2:SUITE 600
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4114
Practice Address - Country:US
Practice Address - Phone:719-314-4260
Practice Address - Fax:719-264-6616
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CO4614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional