MEDICARE: KAYLEIGH RANEE SLOAN MA, LPC, LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0023137	CO
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0002442	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000	OTHER		NOT AVAILABLE

General Provider Information

NPI Number	:	1396469292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEIGH RANEE SLOAN MA, LPC, LAC

Provider Business Mailing Address
First Line	:	1774 KILLDEER CT
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81008-2167
Country	:	US
Telephone Number	:	719-248-5844
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 S. UNION AVE.
Second Line	:	STE. 214
City	:	PUEBLO
State	:	CO
Zip	:	81003
Country	:	US
Telephone Number	:	719-828-3967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	03/20/2026

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