Provider Demographics
NPI:1457499204
Name:KEARNEY, VICKIE LYNN (MA LPC)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:LYNN
Last Name:KEARNEY
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 1:5559 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2959
Mailing Address - Country:US
Mailing Address - Phone:303-730-2956
Mailing Address - Fax:303-797-3567
Practice Address - Street 1:5559 HOLLAND DR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2959
Practice Address - Country:US
Practice Address - Phone:303-730-2956
Practice Address - Fax:303-797-3567
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional