Tracy Kenline is a Clinical in Broomfield, Colorado. Tracy Kenline practices all healthcare services and medical treatments related to Clinical. The NPI Number for Tracy Kenline is 1629199765. The last update date is 2011-11-21.
Tracy Kenline's current location address is 740 Burbank St, Broomfield, Colorado. You can contact this provider via phone number 7204957741 and fax number 8554584470. The mailing address for Tracy Kenline is 740 Burbank St, Broomfield, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracy Kenline |
|---|---|
| Address | 740 Burbank St, Broomfield, Colorado |
| Phone Number | 7204957741 |
| Fax Number | 8554584470 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1629199765 |
|---|---|
| Provider Enumeration Date | 2007-04-03 |
| Last Updated Date | 2011-11-21 |
Provider Mailing Address Detail
| Address | 740 Burbank St |
|---|---|
| City | Broomfield |
| State | Colorado (CO) |
| Post Code | 800201658 |
| Phone Number | 7204957741 |
| Fax Number | 8554584470 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | SW7622 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 12076183 | CO | CAQH | |
| 45-2792123 | CO | TAX ID |
Post Comment/ Review Below
What is the Tracy Kenline's 1629199765?
The Tracy Kenline's NPI (National Provider Identifier) Number is 1629199765. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Tracy Kenline is geographically located?
The Tracy Kenline is physically situated at the following location: 740 Burbank St, Broomfield, CO, 800201658.
What is the Tracy Kenline's specialty and taxonomy code?
The Tracy Kenline's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
When did the Tracy Kenline receive its 1629199765?
The Tracy Kenline was issued its 1629199765 on 2007-04-03, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Tracy Kenline last refreshed?
The information related to the Tracy Kenline, including its address, specialty, and other relevant details, was last updated on 2011-11-21.