Provider Demographics
NPI:1386925139
Name:ROHRER, KEVIN RICHARD (LPC, LMHC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:RICHARD
Last Name:ROHRER
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6545 GLADE PARK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4778
Mailing Address - Country:US
Mailing Address - Phone:719-266-6300
Mailing Address - Fax:
Practice Address - Street 1:5376 TOMAH DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6739
Practice Address - Country:US
Practice Address - Phone:719-331-5077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional