Provider Demographics
NPI:1427080225
Name:DYK, KEVIN J (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:J
Last Name:DYK
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 S MAIN ST
Mailing Address - Street 2:#265
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5376
Mailing Address - Country:US
Mailing Address - Phone:720-274-5270
Mailing Address - Fax:720-274-5267
Practice Address - Street 1:6240 S. MAIN STREET
Practice Address - Street 2:#265
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:720-274-5270
Practice Address - Fax:720-274-5267
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC#2235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional