Provider Demographics
NPI:1992322747
Name:KOSLOSKE, AMBER (MS, LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KOSLOSKE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5155 LAREDO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-2222
Mailing Address - Country:US
Mailing Address - Phone:719-321-9673
Mailing Address - Fax:
Practice Address - Street 1:5155 LAREDO RIDGE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-2222
Practice Address - Country:US
Practice Address - Phone:719-321-9673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-28
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0017567103TC1900X
COLPC.0018590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling