Provider Demographics
NPI:1427228717
Name:KRINARD, COLLEEN M (LCSW)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:M
Last Name:KRINARD
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25343
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86312-5343
Mailing Address - Country:US
Mailing Address - Phone:541-707-7852
Mailing Address - Fax:
Practice Address - Street 1:300 E WILLIS ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3110
Practice Address - Country:US
Practice Address - Phone:928-531-3473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR106051041C0700X
CALCS#189391041C0700X
NMI-075121041C0700X
AZLCSW-229081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical