Healthcare Provider Details

I. General information

NPI: 1184234049
Provider Name (Legal Business Name): KELLUM COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 FLORIDA DR
LOVELAND CO
80538-2442
US

IV. Provider business mailing address

3333 FLORIDA DR
LOVELAND CO
80538-2442
US

V. Phone/Fax

Practice location:
  • Phone: 303-532-7260
  • Fax:
Mailing address:
  • Phone: 303-532-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LU KELLUM
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 303-532-7260