Healthcare Provider Details

I. General information

NPI: 1942079207
Provider Name (Legal Business Name): KIMBERLY KUCERA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13731 E RICE PL STE 102
AURORA CO
80015-1063
US

IV. Provider business mailing address

11455 E 26TH AVE
DENVER CO
80238-4002
US

V. Phone/Fax

Practice location:
  • Phone: 720-383-4564
  • Fax:
Mailing address:
  • Phone: 303-253-5958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0023774
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: