Provider Demographics
NPI:1013258656
Name:HALL, KANEKA D (LCSW, LISW-CP)
Entity Type:Individual
Prefix:MRS
First Name:KANEKA
Middle Name:D
Last Name:HALL
Suffix:
Gender:F
Credentials:LCSW, LISW-CP
Other - Prefix:
Other - First Name:KANEKA
Other - Middle Name:D
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9137 E MINERAL CIR STE 110
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3422
Mailing Address - Country:US
Mailing Address - Phone:303-953-9405
Mailing Address - Fax:303-284-9624
Practice Address - Street 1:9137 E MINERAL CIR STE 110
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3422
Practice Address - Country:US
Practice Address - Phone:303-953-9405
Practice Address - Fax:303-284-9624
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC118151041C0700X
VA09040081601041C0700X
NCC0103781041C0700X
COCSW.099292671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical