Provider Demographics
NPI:1902409154
Name:VI, KIRSTEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:VI
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 1:5488 SPRING RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3373
Mailing Address - Country:US
Mailing Address - Phone:720-234-0571
Mailing Address - Fax:
Practice Address - Street 1:5488 SPRING RIDGE TRL
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-3373
Practice Address - Country:US
Practice Address - Phone:720-234-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical