Healthcare Provider Details

I. General information

NPI: 1649182890
Provider Name (Legal Business Name): ASHLEY MORGAN KENNEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 W 35TH AVE APT 304
WHEAT RIDGE CO
80033-6164
US

IV. Provider business mailing address

PO BOX 2087
ARVADA CO
80001-2087
US

V. Phone/Fax

Practice location:
  • Phone: 303-214-5321
  • Fax:
Mailing address:
  • Phone: 303-214-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2852576
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: