Provider Demographics
NPI:1407948151
Name:KINSEY, GEORGE M (MED LPC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:KINSEY
Suffix:
Gender:M
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62129
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80962-2129
Mailing Address - Country:US
Mailing Address - Phone:719-597-8990
Mailing Address - Fax:719-597-3608
Practice Address - Street 1:3055 AUSTIN BLUFFS PKWY STE A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5758
Practice Address - Country:US
Practice Address - Phone:719-597-8990
Practice Address - Fax:719-597-3608
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional