Provider Demographics
NPI:1598906281
Name:HAFLETT, KRISTEN E (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:HAFLETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:E
Other - Last Name:KOEPPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:624 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7026
Mailing Address - Country:US
Mailing Address - Phone:412-337-9355
Mailing Address - Fax:
Practice Address - Street 1:5855 LEHMAN DR STE 202
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3492
Practice Address - Country:US
Practice Address - Phone:719-377-5335
Practice Address - Fax:719-377-5929
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126691104100000X
PACW0167621041C0700X
CO18371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker