Provider Demographics
NPI:1467239400
Name:KILGORE, YANA (MA, LAC, APPROVED DV)
Entity Type:Individual
Prefix:MRS
First Name:YANA
Middle Name:
Last Name:KILGORE
Suffix:
Gender:F
Credentials:MA, LAC, APPROVED DV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18909 E WARREN CIR UNIT A-204
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-5971
Mailing Address - Country:US
Mailing Address - Phone:720-936-3818
Mailing Address - Fax:
Practice Address - Street 1:18909 E WARREN CIR UNIT A-204
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-5971
Practice Address - Country:US
Practice Address - Phone:720-936-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0021271101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)