Provider Demographics
NPI:1780842070
Name:THOENE, KELLY HOLMES (LCSW AND CACII)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:HOLMES
Last Name:THOENE
Suffix:
Gender:F
Credentials:LCSW AND CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 N. GARFIELD AVE. STE. 203
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2237
Mailing Address - Country:US
Mailing Address - Phone:970-494-4261
Mailing Address - Fax:970-399-8038
Practice Address - Street 1:1170 W ASH ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4782
Practice Address - Country:US
Practice Address - Phone:970-350-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0997119101YA0400X
CO8071041C0700X
COCSW.00000807104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical