Healthcare Provider Details

I. General information

NPI: 1174431886
Provider Name (Legal Business Name): KIMBERLEY NOELLE MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5657 S HIMALAYA ST STE 100
AURORA CO
80015-5308
US

IV. Provider business mailing address

10387 HARRISBURG ST
PARKER CO
80134-5794
US

V. Phone/Fax

Practice location:
  • Phone: 303-699-6200
  • Fax:
Mailing address:
  • Phone: 720-644-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0024422
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: