Provider Demographics
NPI:1770678443
Name:KINNAN, DEB (LPC)
Entity Type:Individual
Prefix:
First Name:DEB
Middle Name:
Last Name:KINNAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N NEVADA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1073
Mailing Address - Country:US
Mailing Address - Phone:719-238-1408
Mailing Address - Fax:719-260-1680
Practice Address - Street 1:611 N NEVADA AVE STE 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1073
Practice Address - Country:US
Practice Address - Phone:719-238-1408
Practice Address - Fax:719-260-1680
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional