Provider Demographics
NPI:1285841734
Name:TAKEUCHI, KAZUHIKO (MA)
Entity Type:Individual
Prefix:
First Name:KAZUHIKO
Middle Name:
Last Name:TAKEUCHI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1324
Mailing Address - Country:US
Mailing Address - Phone:720-620-0894
Mailing Address - Fax:
Practice Address - Street 1:980 11TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7205
Practice Address - Country:US
Practice Address - Phone:303-444-9126
Practice Address - Fax:303-247-9299
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health