Provider Demographics
NPI:1477004356
Name:LEWIS, KRISTEN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 DAGNY WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8013
Mailing Address - Country:US
Mailing Address - Phone:303-416-6128
Mailing Address - Fax:
Practice Address - Street 1:2770 DAGNY WAY STE 210
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8013
Practice Address - Country:US
Practice Address - Phone:303-416-6128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF81275101YM0800X
CA101547106H00000X
CO0001706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health