MEDICARE: JOHN R KINNAIRD LCSW

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	992834	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447380753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R KINNAIRD LCSW

Provider Business Mailing Address
First Line	:	1913 SHEELY DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1939
Country	:	US
Telephone Number	:	970-305-5260
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 S HOWES ST # B100
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2871
Country	:	US
Telephone Number	:	970-305-5260
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	06/09/2019

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