MEDICARE: KELLY COUNSELING SERVICES, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1134986425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLY COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	1681 CLARENDON DR
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-2887
Country	:	US
Telephone Number	:	970-430-6127
Fax Number	:

Provider Business Practice Location Address
First Line	:	760 WHALERS WAY UNIT 10
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3370
Country	:	US
Telephone Number	:	970-430-6127
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	DAMOND DOTSON
Credential	:	PHD LMFT
Telephone Number	:	970-576-1717

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	03/04/2024

Similar Medicare Providers

1356335392 — MR. ROGER A COUGHLAN LCSW
Practice Location Address:

760 WHALERS WAY , C-200
FT COLLINS, CO
80525-3370

Practice Phone: 970-495-4851
Practice Fax: 970-204-7883

1194884320 — NADINE LOUISE THOMSEN PSY.D.
Practice Location Address:

760 WHALERS WAY , C-200
FORT COLLINS, CO
80525-3370

Practice Phone: 970-495-4856
Practice Fax: 970-204-7883

1093876484 — JIM R KLOCK LCSW
Practice Location Address:

760 WHALERS WAY , SUITE C-200
FORT COLLINS, CO
80525-3370

Practice Phone: 970-495-4853
Practice Fax: 970-204-7883

1144378324 — MR. TERRY J. PASQUIN M.S.W.
Practice Location Address:

760 WHALERS WAY , C-200
FORT COLLINS, CO
80525-3370

Practice Phone: 970-495-4855
Practice Fax: 970-204-7883

1700288065 — DR. SHOSHANNA SHACHTMAN ED.D, LPC, NCC
Practice Location Address:

760 WHALERS WAY STE 100
FORT COLLINS, CO
80525-3370

Practice Phone: 720-380-3725
Practice Fax:

1760927180 — REBECCA TEMPLE
Practice Location Address:

760 WHALERS WAY STE 100
FORT COLLINS, CO
80525-3370

Practice Phone: 970-541-1116
Practice Fax:

Directions to “KELLY COUNSELING SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.