Provider Demographics
NPI:1194574822
Name:CHILDS, KERRI (MA, LPCC, NCC)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:CHILDS
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6069 WINDY WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3294
Mailing Address - Country:US
Mailing Address - Phone:512-981-9440
Mailing Address - Fax:
Practice Address - Street 1:1635 FOXTRAIL DR STE 112
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9086
Practice Address - Country:US
Practice Address - Phone:970-430-6138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health