Provider Demographics
NPI:1154180834
Name:CRESTONE MENTAL HEALTH
Entity type:Organization
Organization Name:CRESTONE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAMZI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:303-419-9215
Mailing Address - Street 1:3360 ELIMA ST APT C
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1010
Mailing Address - Country:US
Mailing Address - Phone:303-419-9215
Mailing Address - Fax:866-920-6581
Practice Address - Street 1:8125 N 41ST ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7038
Practice Address - Country:US
Practice Address - Phone:303-419-9215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty