Provider Demographics
NPI:1386353969
Name:FREW, KAILYN (LSW)
Entity type:Individual
Prefix:
First Name:KAILYN
Middle Name:
Last Name:FREW
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 BARNES RD STE 245
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1564
Mailing Address - Country:US
Mailing Address - Phone:719-600-9455
Mailing Address - Fax:
Practice Address - Street 1:4440 BARNES RD STE 245
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-1564
Practice Address - Country:US
Practice Address - Phone:719-600-9455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009925477104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker