Provider Demographics
NPI:1932412608
Name:BICKELHAUPT, KRISTA LEIGH (MS BCBA , LPC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:LEIGH
Last Name:BICKELHAUPT
Suffix:
Gender:F
Credentials:MS BCBA , LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6798 E RUSTIC DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8042
Mailing Address - Country:US
Mailing Address - Phone:303-815-9652
Mailing Address - Fax:
Practice Address - Street 1:6798 E RUSTIC DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8042
Practice Address - Country:US
Practice Address - Phone:303-815-9652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-08-4087103K00000X
COLPC.0013521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC.0013521OtherLPC LICENSE
1-08-4087OtherBEHAVIOR ANALYST CERTIFICATION BOARD