Provider Demographics
NPI:1417350083
Name:CARLSON, KELSEY (MSW)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 S TAMARAC DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4360
Mailing Address - Country:US
Mailing Address - Phone:303-901-2614
Mailing Address - Fax:303-309-6715
Practice Address - Street 1:3201 S TAMARAC DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231
Practice Address - Country:US
Practice Address - Phone:303-901-2614
Practice Address - Fax:303-309-6715
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099248931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical