Provider Demographics
NPI:1942342183
Name:GANT, KARI DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:DAWN
Last Name:GANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:DAWN
Other - Last Name:GANT, TERRILL, CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911057
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1057
Mailing Address - Country:US
Mailing Address - Phone:888-269-7001
Mailing Address - Fax:303-764-6640
Practice Address - Street 1:1008 MINNEQUA AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3733
Practice Address - Country:US
Practice Address - Phone:719-557-4899
Practice Address - Fax:719-557-4060
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0002957101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000160493Medicaid