Provider Demographics
NPI:1649055666
Name:JANTZ, KAILA (MSW, LSW)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:JANTZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12157 W CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2100
Mailing Address - Country:US
Mailing Address - Phone:720-773-1439
Mailing Address - Fax:
Practice Address - Street 1:8190 E 1ST AVE STE 105
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7211
Practice Address - Country:US
Practice Address - Phone:303-731-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099246701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical