Provider Demographics
NPI:1922382357
Name:LAVINDER DUBNER, KRISTEN ELIZABETH (MA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:LAVINDER DUBNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:LAVINDER AND KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:15859 E JAMISON DR APT 16106
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4680
Mailing Address - Country:US
Mailing Address - Phone:720-560-5511
Mailing Address - Fax:
Practice Address - Street 1:15859 E JAMISON DR APT 16106
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4680
Practice Address - Country:US
Practice Address - Phone:720-560-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013913101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health