Healthcare Provider Details

I. General information

NPI: 1225942188
Provider Name (Legal Business Name): KAITLYN ELIZABETH RADEL ADDC,LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S DIVISION AVE
STERLING CO
80751-4110
US

IV. Provider business mailing address

1644 S COLLEGE AVE
FORT COLLINS CO
80525-1007
US

V. Phone/Fax

Practice location:
  • Phone: 970-380-7885
  • Fax:
Mailing address:
  • Phone: 970-221-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0000769
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0025029
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: