Healthcare Provider Details

I. General information

NPI: 1952800492
Provider Name (Legal Business Name): BRIANNA KELLER MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

IV. Provider business mailing address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-8742
  • Fax:
Mailing address:
  • Phone: 720-507-8742
  • Fax: 303-450-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0015907
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0015701
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: