Provider Demographics
NPI:1295744142
Name:KUPFER, JEFFREY H (PHD, PSYD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:KUPFER
Suffix:
Gender:
Credentials:PHD, PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 S POTOMAC ST STE 112
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4527
Mailing Address - Country:US
Mailing Address - Phone:720-845-6675
Mailing Address - Fax:
Practice Address - Street 1:1630 DRY CREEK DR STE 100-B
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-6409
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:888-965-4615
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7304103T00000X
NE575103T00000X
CO1-00-0058103K00000X
CO2277103T00000X
1-00-0058103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12952320Medicaid
CO70224871Medicaid
COC83466Medicare PIN