Healthcare Provider Details

I. General information

NPI: 1417760547
Provider Name (Legal Business Name): TAYLOR CAROLINE KINSMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 GRAND AVE
GLENWOOD SPRINGS CO
81601-4428
US

IV. Provider business mailing address

PO BOX 275
GYPSUM CO
81637-0275
US

V. Phone/Fax

Practice location:
  • Phone: 970-328-6969
  • Fax:
Mailing address:
  • Phone: 720-271-7664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0021840
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: