Provider Demographics
NPI:1780849760
Name:CRAIG ACKNIPPENBERG, LCSW, MDV, PC
Entity Type:Organization
Organization Name:CRAIG ACKNIPPENBERG, LCSW, MDV, PC
Other - Org Name:KNIPPENBERG, PATTERSON, LANGLEY & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNIPPENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-756-4924
Mailing Address - Street 1:3179 S FOREST ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7350
Mailing Address - Country:US
Mailing Address - Phone:303-756-4924
Mailing Address - Fax:303-756-5204
Practice Address - Street 1:2650 S. EUDORA ST.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-756-4924
Practice Address - Fax:303-756-5204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO989-2741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty