Healthcare Provider Details

I. General information

NPI: 1801135090
Provider Name (Legal Business Name): KALLEN AKERS THORNTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 502
DENVER CO
80220-3910
US

IV. Provider business mailing address

2480 S GILPIN ST
DENVER CO
80210-5133
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-2944
  • Fax:
Mailing address:
  • Phone: 512-810-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09924628
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: