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General NPI Number Information
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NPI Number | 1013809474
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Entity Type | Individual
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Provider Name | KIARA DEL ROSARIO RAFAEL B.S, M.A, LPCC
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Gender |
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 275 S MAIN ST STE 201
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City | LONGMONT
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State | CO
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Zip | 80501-6461
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Country | US
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Telephone | 970-541-4189
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 GRANT ST
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City | LONGMONT
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State | CO
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Zip | 80501-3710
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Country | US
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Telephone | 970-402-2246
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0023606
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License Number State | CO
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