Provider Demographics
NPI:1790854347
Name:KELSO, ADELE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ADELE
Middle Name:
Last Name:KELSO
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 1943
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1504
Mailing Address - Country:US
Mailing Address - Phone:303-993-6071
Mailing Address - Fax:720-667-2997
Practice Address - Street 1:753 MALETA LN STE 203
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:303-993-6071
Practice Address - Fax:720-667-2997
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 208951041C0700X
COCSW.000013001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical