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NPI Code Detail

MEDICARE: KELLY L ROPER

MEDICARE: KELLY L ROPER
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
11041C0700XClinical Social WorkerCSW.09931905CO

General Provider Information

NPI Number : 1750151346
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY L ROPER
Provider Business Mailing Address
First Line : 1586 S 21ST ST STE 20
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-4260
Country : US
Telephone Number : 405-210-6683
Fax Number : 405-251-8538
Provider Business Practice Location Address
First Line : 1586 S 21ST ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-4282
Country : US
Telephone Number : 405-210-6683
Fax Number : 405-251-8538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2024
Last Update Date : 06/16/2025

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