Provider Demographics
NPI:1760846653
Name:SCANNELL, KELLEE
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:
Last Name:SCANNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLEE
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8461 TURNPIKE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4379
Mailing Address - Country:US
Mailing Address - Phone:720-295-2424
Mailing Address - Fax:
Practice Address - Street 1:8461 TURNPIKE DR STE 208
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4379
Practice Address - Country:US
Practice Address - Phone:720-295-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0013524106H00000X
AZLAMFT-10451106H00000X
COMFT.0001532106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist