Provider Demographics
NPI:1295157592
Name:KRUSH COUNSELING
Entity type:Organization
Organization Name:KRUSH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:KRUSH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CACIII, NCC
Authorized Official - Phone:605-430-0954
Mailing Address - Street 1:2500 30TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1238
Mailing Address - Country:US
Mailing Address - Phone:605-430-0954
Mailing Address - Fax:720-550-8637
Practice Address - Street 1:2500 30TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1238
Practice Address - Country:US
Practice Address - Phone:605-430-0954
Practice Address - Fax:720-550-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11757251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health