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NPI Code Detail

MEDICARE: MRS. KYLE BETH TICK LCSW

MEDICARE:  MRS. KYLE BETH TICK  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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1700913506
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KYLE BETH TICK LCSW
Provider Business Mailing Address
First Line : 30702 ELDORA CT
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-9409
Country : US
Telephone Number : 720-363-8191
Fax Number :
Provider Business Practice Location Address
First Line : 1325 S COLORADO BLVD # B108
Second Line :
City : DENVER
State : CO
Zip : 80222-3033
Country : US
Telephone Number : 720-363-8191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 04/21/2020

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Directions to “ MRS. KYLE BETH TICK LCSW” Practice Location

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