Provider Demographics
NPI:1023128071
Name:NADLER, KIM (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:NADLER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 LAKE GULCH RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-8962
Mailing Address - Country:US
Mailing Address - Phone:720-733-8587
Mailing Address - Fax:303-688-5553
Practice Address - Street 1:340 PERRY ST
Practice Address - Street 2:SUITE 220
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2499
Practice Address - Country:US
Practice Address - Phone:720-733-8587
Practice Address - Fax:303-688-5553
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO575106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist