Healthcare Provider Details

I. General information

NPI: 1790191575
Provider Name (Legal Business Name): JASMINE MICHELE KINDRED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S ACOMA ST
DENVER CO
80223-3671
US

IV. Provider business mailing address

4141 E DICKENSON PL
DENVER CO
80222-6012
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-6565
  • Fax:
Mailing address:
  • Phone: 303-504-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberNLC 0103125
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number0103125
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: