Provider Demographics
NPI:1033411798
Name:BERT, KEVIN JAMES (LCSW, CACIII)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JAMES
Last Name:BERT
Suffix:
Gender:M
Credentials:LCSW, CACIII
Other - Prefix:
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Mailing Address - Street 1:8801 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4950
Mailing Address - Country:US
Mailing Address - Phone:303-960-6249
Mailing Address - Fax:303-537-6923
Practice Address - Street 1:8801 E HAMPDEN AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4950
Practice Address - Country:US
Practice Address - Phone:303-960-6249
Practice Address - Fax:303-537-6923
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COACC-6523101YA0400X
COCSW-3601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)