Healthcare Provider Details

I. General information

NPI: 1235944422
Provider Name (Legal Business Name): KATHLEEN KEELAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15713 W 70TH DR
ARVADA CO
80007-6904
US

IV. Provider business mailing address

15713 W 70TH DR
ARVADA CO
80007-6904
US

V. Phone/Fax

Practice location:
  • Phone: 720-668-2993
  • Fax:
Mailing address:
  • Phone: 720-668-2993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0002696
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: