Provider Demographics
NPI:1477997906
Name:CROSS, KAYLI ANN (LMFT-S)
Entity Type:Individual
Prefix:
First Name:KAYLI
Middle Name:ANN
Last Name:CROSS
Suffix:
Gender:F
Credentials:LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 E YAMPA ST STE 4
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5061
Mailing Address - Country:US
Mailing Address - Phone:940-343-9226
Mailing Address - Fax:
Practice Address - Street 1:2720 E YAMPA ST STE 4
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5061
Practice Address - Country:US
Practice Address - Phone:940-343-9226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201562106H00000X
COMFT.0001737106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist