Provider Demographics
NPI:1437979713
Name:BROWN, KAILEY JOANNE
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:JOANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N MILLER ST
Mailing Address - Street 2:
Mailing Address - City:KEENESBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80643-9077
Mailing Address - Country:US
Mailing Address - Phone:303-476-0145
Mailing Address - Fax:
Practice Address - Street 1:10190 BANNOCK ST STE 120
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80260-6052
Practice Address - Country:US
Practice Address - Phone:720-826-3498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor