KEVIN CANNELLA (NPI# 1578031852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578031852 |
| Entity Type | Individual |
| Full Name | KEVIN CANNELLA |
| Credential | LPCC |
| Practice Address |
3050 Broadway St Boulder CO 80304-3154 |
| Mailing Address |
2275 Spruce St Boulder CO 80302-4626 |
| Practice Telephone | 4109135989 |
| Mailing Telephone | 4109135989 |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2018-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPCC.0016287 | CO | Behavioral Health & Social Service Providers |
| Street Address |
3050 BROADWAY ST |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912129545 | Cristina Lee Shaw | Social Worker | 3050 Broadway St, Boulder, CO 80304-3154 | 2007-05-03 |
| 1881220440 | Gretchen Leezer | Counselor | 3050 Broadway St, Boulder, CO 80304-3154 | 2020-03-16 |
| 1184267338 | Anxiety and Ocd Unstuck | Social Worker | 3050 Broadway St, Boulder, CO 80304-3154 | 2019-10-21 |
| 1508338971 | Stephanie Lynn Hopkins | Dietitian, Registered | 3050 Broadway St, Boulder, CO 80304-3154 | 2018-12-26 |
| 1851740625 | Marc Azoulay | Counselor | 3050 Broadway St, Suite 300, Boulder, CO 80304-3154 | 2016-06-12 |
| 1629230537 | Rowena Nicole Baca | Counselor | 3050 Broadway St, Boulder, CO 80304-3154 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558107 | Alec Farbman | Counselor | 1941 Pearl St Unit 202, Boulder, CO 80302-4467 | 2020-11-08 |
| 1942801378 | Chloe Sari Koeffler | Counselor | 2919 Valmont Rd Ste 209, Boulder, CO 80301-1350 | 2020-11-03 |
| 1114527660 | Anneva Noelle Knapp Garner | Counselor | 3363 Hickok Pl, Boulder, CO 80301-1984 | 2020-10-26 |
| 1215535828 | Emily Forse | Counselor | 1501 Yarmouth Ave Unit C-18, Boulder, CO 80304-0564 | 2020-10-15 |
| 1174121875 | Chris Cannon | Counselor | 3450 Hayden Pl Apt 3, Boulder, CO 80301-1929 | 2020-10-14 |
| 1992303911 | Riese Rose | Counselor | 4478 Hamilton Ct, Boulder, CO 80305-5554 | 2020-10-12 |
| 1477151728 | Karina Maria Tibble | Counselor | 5378 Sterling Dr # 1, Boulder, CO 80301-2351 | 2020-10-09 |
| 1902403538 | Brianna Kaylin Jones | Counselor | 2024 Goss St Apt 5, Boulder, CO 80302-6577 | 2020-10-06 |
| 1063029510 | Ryan O'millian | Counselor | 2919 Valmont Rd Ste 206, Boulder, CO 80301-1350 | 2020-09-29 |
| 1073123691 | Corinne Schuele | Counselor | 2299 Pearl St Ste 400a, Boulder, CO 80302-4673 | 2020-08-07 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.