Provider Demographics
NPI:1154652105
Name:KUNKEL, EMILY SUSANNE (LCSW, MSW,)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUSANNE
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:LCSW, MSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11819 RIDGE PKWY APT 924
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6500
Mailing Address - Country:US
Mailing Address - Phone:815-440-6479
Mailing Address - Fax:
Practice Address - Street 1:439 EDWARDS ACCESS RD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-5634
Practice Address - Country:US
Practice Address - Phone:970-445-2489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical