Provider Demographics
NPI:1417245598
Name:DEWEY, KRISTAN CAYE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KRISTAN
Middle Name:CAYE
Last Name:DEWEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 S LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2604
Mailing Address - Country:US
Mailing Address - Phone:614-204-4573
Mailing Address - Fax:
Practice Address - Street 1:2460 W 26TH AVE
Practice Address - Street 2:SUITE 450-C
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5308
Practice Address - Country:US
Practice Address - Phone:303-429-5099
Practice Address - Fax:303-432-6190
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6133101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional