Provider Demographics
NPI:1134331903
Name:KRUPNICK COUNSELING ASSOCIATES PC
Entity Type:Organization
Organization Name:KRUPNICK COUNSELING ASSOCIATES PC
Other - Org Name:LONGMONT EMPLOYEE ASSISTANCE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DEVELOPMENT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEHLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-651-1515
Mailing Address - Street 1:500 KIMBARK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5583
Mailing Address - Country:US
Mailing Address - Phone:303-651-1515
Mailing Address - Fax:720-652-0408
Practice Address - Street 1:500 KIMBARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5583
Practice Address - Country:US
Practice Address - Phone:303-651-1515
Practice Address - Fax:720-652-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1832103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty