1265200968 NPI number — COURTNEY KIRK CHAMBERS M.S., CCC-SLP

Table of content: COURTNEY KIRK CHAMBERS M.S., CCC-SLP (NPI 1265200968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265200968 NPI number — COURTNEY KIRK CHAMBERS M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAMBERS
Provider First Name:
COURTNEY
Provider Middle Name:
KIRK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KIRK
Provider Other First Name:
COURTNEY
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265200968
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27890 E 7TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80018-1840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-364-8489
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9350 TEDDY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONE TREE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80124-2876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-387-0853
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SLP.0003579 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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