Individual
KYLE ROTHFORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LAC
Contact information
Practice address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
(303) 443-8500
Mailing address
280 CARMELLO CIR, CONWAY, SC 29526-7951
(864) 328-7046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0002088
CO
101YP2500X
Professional Counselor
LPCC.0018000
CO
Other
Enumeration date
12/30/2020
Last updated
03/22/2023
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