Individual
KEVIN PATRICK GILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
4141 E DICKENSON PL, DENVER, CO 80222-6012
(303) 504-6500
Mailing address
4141 E DICKENSON PL, DENVER, CO 80222-6012
(303) 504-6500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0001731
CO
104100000X
Social Worker
0009921601
CO
1041C0700X
Clinical Social Worker
Primary
09927412
CO
Other
Enumeration date
04/10/2019
Last updated
07/26/2021
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