Provider Demographics
NPI:1063163343
Name:KILIMNIK, CHELSEA (PHD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:KILIMNIK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 CARBON PL STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-6164
Mailing Address - Country:US
Mailing Address - Phone:720-295-0558
Mailing Address - Fax:
Practice Address - Street 1:3020 CARBON PL STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-6164
Practice Address - Country:US
Practice Address - Phone:720-295-0558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14702103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist