Healthcare Provider Details

I. General information

NPI: 1659837870
Provider Name (Legal Business Name): ALICE TOBIN KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 MAXWELL ST
COLORADO SPRINGS CO
80906-5554
US

IV. Provider business mailing address

62 MCBURNEY BLVD
COLORADO SPRINGS CO
80911-2036
US

V. Phone/Fax

Practice location:
  • Phone: 719-419-7959
  • Fax: 719-374-3966
Mailing address:
  • Phone: 719-419-7959
  • Fax: 719-374-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0001521
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: