Provider Demographics
NPI:1295470078
Name:HARRINGTON, KAYLEY JO (LCSW)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:JO
Last Name:HARRINGTON
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 1:2566 E CARAMILLO ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3070
Mailing Address - Country:US
Mailing Address - Phone:202-257-3454
Mailing Address - Fax:
Practice Address - Street 1:2566 E CARAMILLO ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3070
Practice Address - Country:US
Practice Address - Phone:202-257-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA927661041C0700X
RIISW036381041C0700X
CO099275571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09927557OtherCO DEPARTMENT OF REGULATORY AGENCIES
CA92766OtherBOARD OF BEHAVIORAL SCIENCES CA
RIISW03638OtherRI DEPARTMENT OF HEALTH