Healthcare Provider Details

I. General information

NPI: 1881527117
Provider Name (Legal Business Name): KITK EDWARD JONES
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 S OAKLAND CIR
AURORA CO
80014-1816
US

IV. Provider business mailing address

2402 S OAKLAND CIR
AURORA CO
80014-1816
US

V. Phone/Fax

Practice location:
  • Phone: 720-393-0366
  • Fax: 720-393-0366
Mailing address:
  • Phone: 720-393-0366
  • Fax: 720-393-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: