Provider Demographics
NPI:1386217602
Name:SOLTIS, KIRBY PINK (LPC)
Entity Type:Individual
Prefix:
First Name:KIRBY
Middle Name:PINK
Last Name:SOLTIS
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 1:445 WHEAT BERRY DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-6825
Mailing Address - Country:US
Mailing Address - Phone:970-567-9137
Mailing Address - Fax:
Practice Address - Street 1:100 ARAPAHOE AVE # 9
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5854
Practice Address - Country:US
Practice Address - Phone:303-219-0238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016775101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health