Provider Demographics
NPI:1508365487
Name:HAYES, KELLI (LCSW)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201-0382
Mailing Address - Country:US
Mailing Address - Phone:720-689-4958
Mailing Address - Fax:
Practice Address - Street 1:1622 RACE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:720-689-4958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099280281041C0700X
COLSW.00099229331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09928028OtherDORA