Provider Demographics
NPI:1407586589
Name:SCHMADERER, KALEN KAMAU (BACHELOR'S DEGREE)
Entity Type:Individual
Prefix:MR
First Name:KALEN
Middle Name:KAMAU
Last Name:SCHMADERER
Suffix:
Gender:M
Credentials:BACHELOR'S DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-7327
Mailing Address - Country:US
Mailing Address - Phone:402-416-8864
Mailing Address - Fax:
Practice Address - Street 1:5215 NEWTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-7327
Practice Address - Country:US
Practice Address - Phone:402-416-8864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEH13720132106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician