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NPI Code Detail

MEDICARE: BRENNA MAE KAHLE LSW

MEDICARE: BRENNA MAE KAHLE LSW
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
1101YA0400XAddiction (Substance Use Disorder) CounselorACD.0002923CO
2104100000XSocial WorkerLSW.0009926233CO

General Provider Information

NPI Number : 1609667369
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENNA MAE KAHLE LSW
Provider Business Mailing Address
First Line : 150 MERCURY VILLAGE DR
Second Line :
City : DURANGO
State : CO
Zip : 81301-8955
Country : US
Telephone Number : 970-335-2342
Fax Number : 970-335-2348
Provider Business Practice Location Address
First Line : 150 MERCURY VILLAGE DR
Second Line :
City : DURANGO
State : CO
Zip : 81301-8955
Country : US
Telephone Number : 970-335-2342
Fax Number : 970-335-2438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2025
Last Update Date : 04/17/2026

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Directions to “ BRENNA MAE KAHLE LSW” Practice Location

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