Provider Demographics
NPI:1902188733
Name:VEHIGE, KIM LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:LEE
Last Name:VEHIGE
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 1:559 VINVENT ST
Mailing Address - Street 2:ATTN: 21 MDOS/SGOHF-MENTAL HEALTH
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-2273
Mailing Address - Fax:866-867-7926
Practice Address - Street 1:559 VINVENT
Practice Address - Street 2:ATTN: 21 MDOS/SGOHF-MENTAL HEALTH
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-2273
Practice Address - Fax:866-867-7926
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical