Provider Demographics
NPI:1801667274
Name:ELLIOTT, KAYLE K (LPC)
Entity type:Individual
Prefix:
First Name:KAYLE
Middle Name:K
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 E 14TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2334
Mailing Address - Country:US
Mailing Address - Phone:419-481-0290
Mailing Address - Fax:
Practice Address - Street 1:1640 N LOGAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-1216
Practice Address - Country:US
Practice Address - Phone:419-481-0290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0020161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health