Healthcare Provider Details

I. General information

NPI: 1164032827
Provider Name (Legal Business Name): KIDSTUFF CHILD AND FAMILY COUNSELING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 17TH AVE STE 92
LONGMONT CO
80501-2647
US

IV. Provider business mailing address

210 E 29TH ST
LOVELAND CO
80538-2742
US

V. Phone/Fax

Practice location:
  • Phone: 970-775-7061
  • Fax:
Mailing address:
  • Phone: 970-775-7061
  • Fax: 970-292-8194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE EVANS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 970-775-7061