Basic Information
| Provider Information | |||||||||
| NPI: | 1477897429 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUEMMERLE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | KUEMMERLE | ||||||||
| OtherFirstName: | JAMES | ||||||||
| OtherMiddleName: | WILLIAM | ||||||||
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| OtherCredential: | MSW, LCSW, ACSW, BCD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 211 W MAIN ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | CO | ||||||||
| PostalCode: | 807513169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9705224549 | ||||||||
| FaxNumber: | 9705229544 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 W MAIN ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | STERLING | ||||||||
| State: | CO | ||||||||
| PostalCode: | 807513169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9705224549 | ||||||||
| FaxNumber: | 9705229544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2012 | ||||||||
| LastUpdateDate: | 03/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW.09923773 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.