Provider Demographics
NPI:1215698832
Name:KIRCHGESSNER, STEPHANIE DEANNA (MS LPCC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DEANNA
Last Name:KIRCHGESSNER
Suffix:
Gender:F
Credentials:MS LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 W 29TH ST STE 1429
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2403
Mailing Address - Country:US
Mailing Address - Phone:970-658-9507
Mailing Address - Fax:
Practice Address - Street 1:1429 W 29TH ST STE 1429
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2403
Practice Address - Country:US
Practice Address - Phone:970-658-9507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty