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General NPI Number Information
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NPI Number | 1598170623
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Entity Type | Individual
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Provider Name | CAITLIN KOZICKI
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Gender | Female
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 7220 W JEFFERSON AVE STE 218
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City | LAKEWOOD
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State | CO
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Zip | 80235-2058
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Country | US
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Telephone | 303-957-6504
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Fax |
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Provider Business Mailing Address
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Address Line | 3633 W GRAMBLING DR
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City | DENVER
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State | CO
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Zip | 80236-2443
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Country | US
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Telephone | 303-957-6504
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0006733
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0005209
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License Number State | CO
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