Provider Demographics
NPI:1588300909
Name:KEVIN FAY, LLC
Entity type:Organization
Organization Name:KEVIN FAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:720-441-6658
Mailing Address - Street 1:191 UNIVERSITY BLVD # 936
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4613
Mailing Address - Country:US
Mailing Address - Phone:720-441-6658
Mailing Address - Fax:
Practice Address - Street 1:1323 ELATI ST UNIT 4
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2707
Practice Address - Country:US
Practice Address - Phone:720-441-6658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)