Provider Demographics
NPI:1083925200
Name:VOUGHT, KERALEE (LCSW)
Entity Type:Individual
Prefix:
First Name:KERALEE
Middle Name:
Last Name:VOUGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12015 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3298
Mailing Address - Country:US
Mailing Address - Phone:707-416-6481
Mailing Address - Fax:
Practice Address - Street 1:12015 GRAPE ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241
Practice Address - Country:US
Practice Address - Phone:707-416-6481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4922502-35011041C0700X
COCSW.099252641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical