Provider Demographics
NPI:1164885190
Name:BEHREND, KACY (CAC II)
Entity Type:Individual
Prefix:
First Name:KACY
Middle Name:
Last Name:BEHREND
Suffix:
Gender:F
Credentials:CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7669 S COVE CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3374
Mailing Address - Country:US
Mailing Address - Phone:720-270-4681
Mailing Address - Fax:
Practice Address - Street 1:667 BANNOCK ST.
Practice Address - Street 2:UNIT 9, PAVILION K
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-602-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000857101YA0400X
COLPC.0013833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)