Provider Demographics
NPI:1154167930
Name:CHIRDON, KEBRINA (BSW)
Entity type:Individual
Prefix:
First Name:KEBRINA
Middle Name:
Last Name:CHIRDON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 LA MONTANA WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6735
Mailing Address - Country:US
Mailing Address - Phone:719-332-1029
Mailing Address - Fax:
Practice Address - Street 1:2270 LA MONTANA WAY STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6735
Practice Address - Country:US
Practice Address - Phone:719-660-5798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health