Provider Demographics
NPI:1750420840
Name:CRIM, KELLY Z (LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:Z
Last Name:CRIM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:CRIM
Other - Last Name:SHRUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3900 S. WADSWORTH BLVD SUITE 360
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235
Mailing Address - Country:US
Mailing Address - Phone:720-284-1367
Mailing Address - Fax:
Practice Address - Street 1:3900 S. WADSWORTH BLVD SUITE 360
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235
Practice Address - Country:US
Practice Address - Phone:720-284-1367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health