Provider Demographics
NPI:1427147495
Name:KAPLAN, PETER LOUIS (PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:LOUIS
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 W DRAKE RD
Mailing Address - Street 2:STE. 102
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2884
Mailing Address - Country:US
Mailing Address - Phone:970-223-9953
Mailing Address - Fax:970-223-9954
Practice Address - Street 1:383 W DRAKE RD
Practice Address - Street 2:STE. 102
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2884
Practice Address - Country:US
Practice Address - Phone:970-223-9953
Practice Address - Fax:970-223-9954
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 751103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4012902Medicaid
COC94266Medicare ID - Type Unspecified