Provider Demographics
NPI:1376219055
Name:KENOSIS COUNSELING
Entity Type:Organization
Organization Name:KENOSIS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRIVATE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADDATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-717-8094
Mailing Address - Street 1:2770 ARAPAHOE RD STE 132-1027
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8018
Mailing Address - Country:US
Mailing Address - Phone:303-717-8094
Mailing Address - Fax:
Practice Address - Street 1:2770 ARAPAHOE RD STE 132-1027
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8018
Practice Address - Country:US
Practice Address - Phone:303-717-8094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health