MEDICARE: DARLA KRAFT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2454	CO

General Provider Information

NPI Number	:	1538120084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLA KRAFT LPC

Provider Business Mailing Address
First Line	:	525 W OAK ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2612
Country	:	US
Telephone Number	:	970-494-4300
Fax Number	:	970-494-4301

Provider Business Practice Location Address
First Line	:	2001 S SHIELDS ST
Second Line	:	BLDG K
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1827
Country	:	US
Telephone Number	:	970-494-4200
Fax Number	:	970-494-4240

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/07/2008

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