Provider Demographics
NPI:1609195577
Name:KIMEL, LILA (PHD)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:
Last Name:KIMEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 S PARKER RD STE 290
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5748
Mailing Address - Country:US
Mailing Address - Phone:303-369-1777
Mailing Address - Fax:303-825-2170
Practice Address - Street 1:2170 S PARKER RD STE 290
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5748
Practice Address - Country:US
Practice Address - Phone:720-269-1777
Practice Address - Fax:303-825-2170
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53750071Medicaid
COCOA100786Medicare PIN