Provider Demographics
NPI:1700309903
Name:CHILES, KALEY LYNN (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:KALEY
Middle Name:LYNN
Last Name:CHILES
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3283
Mailing Address - Country:US
Mailing Address - Phone:719-298-4070
Mailing Address - Fax:
Practice Address - Street 1:7710 N UNION BLVD STE 100B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4085
Practice Address - Country:US
Practice Address - Phone:719-357-9088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013546101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional