Provider Demographics
NPI:1932658507
Name:KITTEL, LESLIE SPRING (MA, MM, LPCC, NCC)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:SPRING
Last Name:KITTEL
Suffix:
Gender:F
Credentials:MA, MM, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 MAIN ST, STE 303
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3540
Mailing Address - Country:US
Mailing Address - Phone:970-623-0455
Mailing Address - Fax:
Practice Address - Street 1:1003 MAIN ST, STE 303
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3540
Practice Address - Country:US
Practice Address - Phone:970-623-0455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
COLPC-PENDING101YP2500X
COLPCC.0015664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)