MEDICARE: KAITLIN JONES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1942079363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAITLIN JONES LLC

Provider Business Mailing Address
First Line	:	375 E HORSETOOTH RD BLDG 4201
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3198
Country	:	US
Telephone Number	:	970-999-0440
Fax Number	:

Provider Business Practice Location Address
First Line	:	375 E HORSETOOTH RD BLDG 4201
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3198
Country	:	US
Telephone Number	:	970-999-0440
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER AND CLINICAL DIRECTOR
Name	:	KAITLIN DOUGLAS
Credential	:	LMFT
Telephone Number	:	970-613-1315

Provider Enumeration Date	:	12/27/2023
Last Update Date	:	12/27/2023

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Directions to “KAITLIN JONES LLC ” Practice Location

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