Provider Demographics
NPI:1811912355
Name:CALHOUN, KEN ALAN (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:KEN
Middle Name:ALAN
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1255 LAKE PLAZA DR
Mailing Address - Street 2:270
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3500
Mailing Address - Country:US
Mailing Address - Phone:719-473-6114
Mailing Address - Fax:719-473-6114
Practice Address - Street 1:1255 LAKE PLAZA DR
Practice Address - Street 2:SUITE 270
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:719-473-6114
Practice Address - Fax:719-473-6114
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2641101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional