Healthcare Provider Details

I. General information

NPI: 1255789517
Provider Name (Legal Business Name): KAYLA JENN KEREKES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 S VAUGHN WAY STE 660
AURORA CO
80014-3514
US

IV. Provider business mailing address

3151 S VAUGHN WAY STE 660
AURORA CO
80014-3514
US

V. Phone/Fax

Practice location:
  • Phone: 720-767-1863
  • Fax: 720-405-4025
Mailing address:
  • Phone: 720-767-1863
  • Fax: 720-405-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLSW.0009920697
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09925919
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: