Provider Demographics
NPI:1851512925
Name:KIDD, LAURIE NATHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:NATHELLE
Last Name:KIDD
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 1:155 S MADISON ST STE 306
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3014
Mailing Address - Country:US
Mailing Address - Phone:866-285-2929
Mailing Address - Fax:208-567-5844
Practice Address - Street 1:2860 MCCLELLAND DR. SUITE 3400
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:866-285-2929
Practice Address - Fax:208-567-5844
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-12-13
Deactivation Date:2018-10-09
Deactivation Code:
Reactivation Date:2018-10-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical