Provider Demographics
NPI:1245582329
Name:RK-S,LCSW, LLC
Entity Type:Organization
Organization Name:RK-S,LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,LLC
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:KAPLAN
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-819-4117
Mailing Address - Street 1:9796 E MAPLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-7018
Mailing Address - Country:US
Mailing Address - Phone:303-819-4117
Mailing Address - Fax:303-270-2174
Practice Address - Street 1:9796 E MAPLEWOOD CIR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-7018
Practice Address - Country:US
Practice Address - Phone:303-819-4117
Practice Address - Fax:303-270-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9898672084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05201009Medicaid
COS54160OtherUPIN