Provider Demographics
NPI:1285257774
Name:KPB CONSULTING, LLC
Entity type:Organization
Organization Name:KPB CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPKINS-BURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-507-0436
Mailing Address - Street 1:479 BIG VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-9359
Mailing Address - Country:US
Mailing Address - Phone:970-507-0436
Mailing Address - Fax:
Practice Address - Street 1:2800 CORNERSTONE DR # 208
Practice Address - Street 2:
Practice Address - City:PAGOSA SPGS
Practice Address - State:CO
Practice Address - Zip Code:81147-8156
Practice Address - Country:US
Practice Address - Phone:970-507-0436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty