Healthcare Provider Details

I. General information

NPI: 1245063445
Provider Name (Legal Business Name): ALLISON REGINA KAYYEM LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 ALCOTT ST
WESTMINSTER CO
80031-4008
US

IV. Provider business mailing address

12702 JULIAN CT
BROOMFIELD CO
80020-5820
US

V. Phone/Fax

Practice location:
  • Phone: 844-566-0787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW.0009924121
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: