Healthcare Provider Details

I. General information

NPI: 1821901497
Provider Name (Legal Business Name): JUSTIN KAKIT LI BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12150 E BRIARWOOD AVE STE 240
CENTENNIAL CO
80112-6756
US

IV. Provider business mailing address

4140 E WARREN AVE UNIT 1
DENVER CO
80222-4949
US

V. Phone/Fax

Practice location:
  • Phone: 408-892-6220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: