Provider Demographics
NPI:1497319677
Name:PEAK-RISHEL, KAILA (LCSW, LMFTC)
Entity Type:Individual
Prefix:MRS
First Name:KAILA
Middle Name:
Last Name:PEAK-RISHEL
Suffix:
Gender:F
Credentials:LCSW, LMFTC
Other - Prefix:
Other - First Name:KAILA
Other - Middle Name:
Other - Last Name:ACKMAN-RISHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:50 S STEELE ST STE 377
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2808
Mailing Address - Country:US
Mailing Address - Phone:734-720-9794
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 377
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2808
Practice Address - Country:US
Practice Address - Phone:734-720-9794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099255171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20161465281OtherPRIVATE PRACTICE