Provider Demographics
NPI:1225009251
Name:KENNEY, NANCY ELLEN (LPC, CAC II)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELLEN
Last Name:KENNEY
Suffix:
Gender:F
Credentials:LPC, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 DRIFTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3169
Mailing Address - Country:US
Mailing Address - Phone:303-931-5204
Mailing Address - Fax:
Practice Address - Street 1:4438 DRIFTWOOD PL
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3169
Practice Address - Country:US
Practice Address - Phone:303-931-5204
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4671101YA0400X
CO2131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health