Provider Demographics
NPI:1063780054
Name:WOODARD, KELLI ANN (MA LCSW)
Entity type:Individual
Prefix:MS
First Name:KELLI
Middle Name:ANN
Last Name:WOODARD
Suffix:
Gender:F
Credentials:MA LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3266 JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2117
Mailing Address - Country:US
Mailing Address - Phone:303-320-3790
Mailing Address - Fax:303-320-4290
Practice Address - Street 1:3201 S TAMARAC DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4360
Practice Address - Country:US
Practice Address - Phone:720-248-4701
Practice Address - Fax:303-597-7700
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-19701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical