Healthcare Provider Details

I. General information

NPI: 1679293856
Provider Name (Legal Business Name): KYLIE BAKERSKY MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6275 JOYCE DR STE 200
GOLDEN CO
80403-7629
US

IV. Provider business mailing address

13227 HOLLY ST UNIT C
THORNTON CO
80241-3194
US

V. Phone/Fax

Practice location:
  • Phone: 719-787-7937
  • Fax:
Mailing address:
  • Phone: 720-841-0786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: