Healthcare Provider Details

I. General information

NPI: 1376462598
Provider Name (Legal Business Name): KAITLYN SCHODT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12631 E 17TH AVE RM 5108
AURORA CO
80045-2527
US

IV. Provider business mailing address

8155 E FAIRMOUNT DR UNIT 635
DENVER CO
80230-6831
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-2080
  • Fax:
Mailing address:
  • Phone: 505-550-6377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6903
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: