Provider Demographics
NPI:1023491487
Name:LUNSTRUM, KRIS (LPCC)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:LUNSTRUM
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 SAINT PAUL ST
Mailing Address - Street 2:APT 305
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2542
Mailing Address - Country:US
Mailing Address - Phone:208-761-8813
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST
Practice Address - Street 2:SUITE 390
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1514
Practice Address - Country:US
Practice Address - Phone:208-761-8813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0013676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPCC.0013676OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES