Provider Demographics
NPI:1184885535
Name:KELLS, KEVIN BARRY (PHD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BARRY
Last Name:KELLS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6393 S RICHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3170
Mailing Address - Country:US
Mailing Address - Phone:303-949-1299
Mailing Address - Fax:
Practice Address - Street 1:6393 S RICHFIELD ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-3170
Practice Address - Country:US
Practice Address - Phone:303-949-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3131103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist