Provider Demographics
NPI:1891473062
Name:LINTHICUM, KAIBA
Entity Type:Individual
Prefix:
First Name:KAIBA
Middle Name:
Last Name:LINTHICUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 W 26TH AVE STE 465C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5315
Mailing Address - Country:US
Mailing Address - Phone:720-893-1415
Mailing Address - Fax:
Practice Address - Street 1:2460 W 26TH AVE STE 465C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5315
Practice Address - Country:US
Practice Address - Phone:720-893-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool