Provider Demographics
NPI:1013352483
Name:YEAGER, KIRK ROBERT II
Entity Type:Individual
Prefix:MR
First Name:KIRK
Middle Name:ROBERT
Last Name:YEAGER
Suffix:II
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 1:4101 E LOUISIANA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3456
Mailing Address - Country:US
Mailing Address - Phone:720-504-7977
Mailing Address - Fax:
Practice Address - Street 1:10310 E JEWELL AVE APT 55
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-3540
Practice Address - Country:US
Practice Address - Phone:303-902-0589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional