1043365745 NPI number — MS. KIRSTEN LYNN WULFSBERG LPC

Table of content: MS. KIRSTEN LYNN WULFSBERG LPC (NPI 1043365745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043365745 NPI number — MS. KIRSTEN LYNN WULFSBERG LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WULFSBERG
Provider First Name:
KIRSTEN
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WULFSBERG
Provider Other First Name:
KIRSTEN
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1043365745
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2465 SOUTH DOWNING ST
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
80210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-778-5774
Provider Business Mailing Address Fax Number:
303-778-2436

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2465 SOUTH DOWNING ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
80210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-778-5774
Provider Business Practice Location Address Fax Number:
303-778-2436
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  2943 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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