Provider Demographics
NPI:1093191405
Name:CHIVERS, KRISTIN LEIGH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:LEIGH
Last Name:CHIVERS
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 1:601 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3407
Mailing Address - Country:US
Mailing Address - Phone:303-656-6278
Mailing Address - Fax:
Practice Address - Street 1:1405 FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2211
Practice Address - Country:US
Practice Address - Phone:303-656-6278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO09925761101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor