Provider Demographics
NPI:1619211158
Name:KRUMHOLZ, DANA L (MA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:KRUMHOLZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4459
Mailing Address - Country:US
Mailing Address - Phone:970-357-6364
Mailing Address - Fax:970-346-9800
Practice Address - Street 1:5401 W 10TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4459
Practice Address - Country:US
Practice Address - Phone:970-357-6364
Practice Address - Fax:970-346-9800
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ACD.000837101YA0400X
COLPC.0011401101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional