Provider Demographics
NPI:1134775505
Name:BRIGHTON, KELSON (LSW)
Entity type:Individual
Prefix:
First Name:KELSON
Middle Name:
Last Name:BRIGHTON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 N SHERMAN ST APT 15
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2257
Mailing Address - Country:US
Mailing Address - Phone:203-803-3616
Mailing Address - Fax:
Practice Address - Street 1:1330 FOX ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2602
Practice Address - Country:US
Practice Address - Phone:203-803-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CO00099226021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical