Individual
KENDRA ELIZABETH WICKLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
(303) 443-8500
Mailing address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001819
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09927949
CO
Other
Enumeration date
08/07/2018
Last updated
11/26/2025
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