Provider Demographics
NPI:1164638417
Name:KALIS, DAVID HOWARD (LCSW PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
Last Name:KALIS
Suffix:
Gender:M
Credentials:LCSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 MCCASLIN BLVD
Mailing Address - Street 2:200
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2941
Mailing Address - Country:US
Mailing Address - Phone:303-482-7041
Mailing Address - Fax:303-416-4356
Practice Address - Street 1:931 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:303-482-7041
Practice Address - Fax:303-665-2994
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO771041C0700X
CO0003755103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical