Basic Information
| Provider Information | |||||||||
| NPI: | 1770871873 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRET | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LSCW, CACII | ||||||||
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| Mailing Information | |||||||||
| Address1: | 715 HORIZON DR | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815068700 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 405 CASTLE CREEK RD | ||||||||
| Address2: | STE 9 | ||||||||
| City: | ASPEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816113125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709205555 | ||||||||
| FaxNumber: | 9709205557 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2011 | ||||||||
| LastUpdateDate: | 04/15/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1863 | CO | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101YA0400X | 7679 | CO | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.