Individual
KATHLEEN KENEFICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1750 30TH ST # 631, BOULDER, CO 80301-1029
(303) 818-9624
Mailing address
1750 30TH ST # 631, BOULDER, CO 80301-1029
(303) 818-9624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0006340
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006340
LPC
CO
01
—
18 002732
LICENSED MENTAL HEALTH COUNSELOR
NY
01
—
B 4172
BOARD CERTIFIED BIOFEEDBACK
CO
Enumeration date
09/19/2016
Last updated
09/19/2016
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