Provider Demographics
NPI:1801135090
Name:THORNTON, KALLEN AKERS (LCSW)
Entity type:Individual
Prefix:
First Name:KALLEN
Middle Name:AKERS
Last Name:THORNTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 S GILPIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5133
Mailing Address - Country:US
Mailing Address - Phone:512-810-2262
Mailing Address - Fax:
Practice Address - Street 1:4545 E 9TH AVE STE 502
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3910
Practice Address - Country:US
Practice Address - Phone:303-320-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099246281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical