Healthcare Provider Details

I. General information

NPI: 1700213402
Provider Name (Legal Business Name): KRISTEN MARISOL KNEEBONE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2013
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 N 12TH ST
GRAND JUNCTION CO
81501-2916
US

IV. Provider business mailing address

2140 N 12TH ST
GRAND JUNCTION CO
81501-2916
US

V. Phone/Fax

Practice location:
  • Phone: 970-462-7329
  • Fax: 970-459-3087
Mailing address:
  • Phone: 970-462-7329
  • Fax: 970-459-3087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09924852
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: