MEDICARE: KELSEY G COCKRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0020173	CO

General Provider Information

NPI Number	:	1093631962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY G COCKRELL

Provider Business Mailing Address
First Line	:	710 COUNTRYSIDE DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3621
Country	:	US
Telephone Number	:	970-219-5137
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 COUNTRYSIDE DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3621
Country	:	US
Telephone Number	:	970-219-5137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “ KELSEY G COCKRELL ” Practice Location

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