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General NPI Number Information
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NPI Number | 1013992296
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Entity Type | Individual
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Provider Name | CAROL A KRYDER LMFT SAP
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Gender | Female
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Dates
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Enumeration Date | 12/11/2005
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 7610 N UNION BLVD SUITE 145
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3891
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Country | US
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Telephone | 719-660-8844
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Fax | 719-594-0116
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Provider Business Mailing Address
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Address Line | 6220 POWDER PUFF DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1615
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Country | US
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Telephone | 719-660-8844
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Fax | 719-594-0116
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | SAP 12243
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT # 1028
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC # 25628
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License Number State | CA
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