Provider Demographics
NPI:1356143507
Name:EHLE-PARKER, KRISTIN (LPCC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:EHLE-PARKER
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 MOUNT SANITAS AVE
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7359
Mailing Address - Country:US
Mailing Address - Phone:970-214-8274
Mailing Address - Fax:
Practice Address - Street 1:5604 MOUNT SANITAS AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7359
Practice Address - Country:US
Practice Address - Phone:970-214-8274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional