Provider Demographics
NPI:1629202601
Name:VANHOLBECK, KENNETH FREDERICK (LMFT)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:FREDERICK
Last Name:VANHOLBECK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 LEHMAN DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1497
Mailing Address - Country:US
Mailing Address - Phone:719-332-8890
Mailing Address - Fax:719-528-2505
Practice Address - Street 1:6285 LEHMAN DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1497
Practice Address - Country:US
Practice Address - Phone:719-332-8890
Practice Address - Fax:719-528-2505
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist