Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LPCC.0016052 | CO |
Y | 101YP2500X | Professional Counselor | LPCC.0016052 | CO |
N | 101YS0200X | School Counselor | LPCC.0016052 | CO |
N | 102L00000X | Psychologist | LPCC.0016052 | CO |
N | 103T00000X | Psychologist | LPCC.0016052 | CO |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | LPCC.0016052 | CO |
N | 103TF0000X | Family Psychologist | LPCC.0016052 | CO |
N | 103TP2701X | Group Psychotherapist | LPCC.0016052 |
NPI | 1104310911 |
---|---|
Provider Name | Mr. James Edward Kessler |
First Address | Boulder, CO 80301-6312 |
Second Address | Boulder, CO 80301-2275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2018 |
Last Update Date | 15/06/2018 |