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General NPI Number Information
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NPI Number | 1780239665
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Entity Type | Individual
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Provider Name | KIRSTEN GONZALEZ MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 1746 COLE BLVD STE 225
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City | GOLDEN
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State | CO
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Zip | 80401-3208
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Country | US
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Telephone | 303-250-1327
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Fax |
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Provider Business Mailing Address
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Address Line | 1191 S BEECH DR APT 106
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City | LAKEWOOD
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State | CO
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Zip | 80228-3440
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Country | US
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Telephone | 702-302-7295
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 14615
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License Number State | CO
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