Provider Demographics
NPI:1740861798
Name:WHIPPLE COUNSELING LLC
Entity type:Organization
Organization Name:WHIPPLE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:JENN
Authorized Official - Last Name:KEREKES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-767-1863
Mailing Address - Street 1:4836 S NUCLA WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1669
Mailing Address - Country:US
Mailing Address - Phone:720-767-1863
Mailing Address - Fax:
Practice Address - Street 1:2010 S BLACKHAWK ST STE 240
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1418
Practice Address - Country:US
Practice Address - Phone:720-767-1863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1255789517Medicaid