Healthcare Provider Details

I. General information

NPI: 1407767106
Provider Name (Legal Business Name): NIKOLAS MICHAEL KRAUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 GUNPARK DR STE 202
BOULDER CO
80301-3579
US

IV. Provider business mailing address

3317 183RD AVE SE
SNOHOMISH WA
98290-9550
US

V. Phone/Fax

Practice location:
  • Phone: 720-491-1142
  • Fax:
Mailing address:
  • Phone: 720-772-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0025402
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: