Provider Demographics
NPI:1053040527
Name:ROM, KAYLEE (LCSW)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:ROM
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 S COLLEGE AVE UNIT 210
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2558
Mailing Address - Country:US
Mailing Address - Phone:970-764-7619
Mailing Address - Fax:
Practice Address - Street 1:3000 S COLLEGE AVE UNIT 210
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2558
Practice Address - Country:US
Practice Address - Phone:970-764-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker