Provider Demographics
NPI:1205568250
Name:SANDELLA, KELSEY LYNNE (MSW, SWC)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNNE
Last Name:SANDELLA
Suffix:
Gender:F
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7131 YAMPA RIVER HTS
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-1570
Mailing Address - Country:US
Mailing Address - Phone:719-985-1325
Mailing Address - Fax:
Practice Address - Street 1:4360 MONTEBELLO DR STE 400
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7224
Practice Address - Country:US
Practice Address - Phone:719-649-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty