Provider Demographics
NPI:1699339523
Name:WHITLEY, KIRA AYNN (LPCC, NCC)
Entity type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:AYNN
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-1760
Mailing Address - Country:US
Mailing Address - Phone:719-244-6738
Mailing Address - Fax:
Practice Address - Street 1:104 S CASCADE AVE STE 111
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5101
Practice Address - Country:US
Practice Address - Phone:719-888-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0016115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional