NPI Code Detail JSON Logo

1598902249 NPI number — KENNETH G. EIELSON II BS

NPI Number: 1598902249
Health Care Provider/Practitioner: KENNETH G. EIELSON II BS

Information about “1598902249” NPI (KENNETH G. EIELSON II BS) exists in 1598902249 in HTML format HTML  |  1598902249 in plain Text format TXT  |  1598902249 in PDF (Portable Document Format) PDF  |  1598902249 in an XML format XML  formats.

NPI Number : 1598902249 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598902249",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EIELSON",
    "FirstName": "KENNETH",
    "MiddleName": "G.",
    "NamePrefix": null,
    "NameSuffix": "II",
    "Credential": "BS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2001 BLAKE AVE STE 1A",
    "SecondLineMailingAddress": "CHI/STORM KING CASE MANAGEMENT",
    "MailingAddressCityName": "GLENWOOD SPRINGS",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "81601-4269",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "970-945-8669",
    "MailingAddressFaxNumber": "970-947-9158",
    "FirstLinePracticeLocationAddress": "6916 HIGHWAY 82",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLENWOOD SPRINGS",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "81601-9435",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-945-2241",
    "PracticeLocationAddressFaxNumber": "970-945-5523",
    "EnumerationDate": "01/17/2009",
    "LastUpdateDate": "03/11/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "6098",
        "LicenseNumberStateCode": "CO",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.