Provider Demographics
NPI:1639978273
Name:LOGAN, KIMBERLY (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:LOGAN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10709 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3619
Mailing Address - Country:US
Mailing Address - Phone:303-883-1926
Mailing Address - Fax:
Practice Address - Street 1:5310 WARD RD STE 110
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1829
Practice Address - Country:US
Practice Address - Phone:720-898-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health