Provider Demographics
NPI:1275054140
Name:ACHRAMOWICZ, KELLYANNE TERESA (MS, NCC, LPC, LAC)
Entity Type:Individual
Prefix:MS
First Name:KELLYANNE
Middle Name:TERESA
Last Name:ACHRAMOWICZ
Suffix:
Gender:F
Credentials:MS, NCC, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 WOODMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9066
Mailing Address - Country:US
Mailing Address - Phone:719-602-3244
Mailing Address - Fax:
Practice Address - Street 1:1865 WOODMOOR DR
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9066
Practice Address - Country:US
Practice Address - Phone:719-602-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001565101YA0400X
COLPCC.0014910101Y00000X
COLPC.0015057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor