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NPI Code Detail

MEDICARE: LAREE KELLY-WARNER, MA, BCBA, P.C.

MEDICARE: LAREE KELLY-WARNER, MA, BCBA, P.C.
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
1103K00000XBehavior Analyst1062879CO

General Provider Information

NPI Number : 1861633604
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAREE KELLY-WARNER, MA, BCBA, P.C.
Provider Business Mailing Address
First Line : PO BOX 76510
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80970-6510
Country : US
Telephone Number : 719-210-7464
Fax Number : 719-638-8115
Provider Business Practice Location Address
First Line : 1322 N ACADEMY BLVD STE 204
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-3320
Country : US
Telephone Number : 719-210-7464
Fax Number : 719-638-8115
Authorized Official
Title or Position : BILLING MANAGER
Name : LAREE KELLY-WARNER
Credential :
Telephone Number : 719-210-7464
Provider Enumeration Date : 03/06/2009
Last Update Date : 05/23/2022

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