Provider Demographics
NPI:1326250796
Name:SABELKO, KENNEDY M (MS LPC)
Entity Type:Individual
Prefix:MR
First Name:KENNEDY
Middle Name:M
Last Name:SABELKO
Suffix:
Gender:M
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-1803
Mailing Address - Country:US
Mailing Address - Phone:970-402-5081
Mailing Address - Fax:
Practice Address - Street 1:13805 ANN PL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-7702
Practice Address - Country:US
Practice Address - Phone:970-402-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326250796OtherNPI