Healthcare Provider Details

I. General information

NPI: 1730095290
Provider Name (Legal Business Name): ADAM KURTZ LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 BROADWAY ST STE B3
BOULDER CO
80304-1169
US

IV. Provider business mailing address

4645 BROADWAY ST STE B3
BOULDER CO
80304-1169
US

V. Phone/Fax

Practice location:
  • Phone: 610-212-8122
  • Fax:
Mailing address:
  • Phone: 610-212-8122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0023649
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: