MEDICARE: KRISTIN LUKELA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0011439	CO

General Provider Information

NPI Number	:	1497387120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN LUKELA LPC

Provider Business Mailing Address
First Line	:	1333 W 120TH AVE STE 218
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-2710
Country	:	US
Telephone Number	:	303-921-7261
Fax Number	:	303-469-1589

Provider Business Practice Location Address
First Line	:	1333 W 120TH AVE STE 218
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-2710
Country	:	US
Telephone Number	:	303-921-7261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2020
Last Update Date	:	02/11/2020

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