Provider Demographics
NPI:1356584569
Name:ELMORE, KRISTENE W (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:KRISTENE
Middle Name:W
Last Name:ELMORE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13950 UMPIRE ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80603-8888
Mailing Address - Country:US
Mailing Address - Phone:303-659-6743
Mailing Address - Fax:
Practice Address - Street 1:13950 UMPIRE ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80603-8888
Practice Address - Country:US
Practice Address - Phone:303-659-6743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional