Provider Demographics
NPI:1932290525
Name:KRUPNICK, LOUIS (EDD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:KRUPNICK
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KIMBARK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5583
Mailing Address - Country:US
Mailing Address - Phone:303-651-1515
Mailing Address - Fax:720-652-0408
Practice Address - Street 1:500 KIMBARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5583
Practice Address - Country:US
Practice Address - Phone:303-651-1515
Practice Address - Fax:720-652-0408
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1832103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1832OtherSTATE LICENSE