Provider Demographics
NPI:1477897429
Name:KUEMMERLE, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KUEMMERLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:WILLIAM
Other - Last Name:KUEMMERLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW, ACSW, BCD
Mailing Address - Street 1:211 W MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3169
Mailing Address - Country:US
Mailing Address - Phone:970-522-4549
Mailing Address - Fax:970-522-9544
Practice Address - Street 1:211 W MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3169
Practice Address - Country:US
Practice Address - Phone:970-522-4549
Practice Address - Fax:970-522-9544
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099237731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical