Provider Demographics
NPI:1528416252
Name:CROSWAITE COUNSELING, PLLC
Entity Type:Organization
Organization Name:CROSWAITE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSWAITE BRINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-245-7390
Mailing Address - Street 1:7700 E ACADEMY BLVD
Mailing Address - Street 2:#305
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7167
Mailing Address - Country:US
Mailing Address - Phone:720-245-7390
Mailing Address - Fax:
Practice Address - Street 1:495 UINTA WAY
Practice Address - Street 2:SUITE 120
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7110
Practice Address - Country:US
Practice Address - Phone:720-245-7390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty