Kid Crew, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12091959

Legal business name

KID CREW, LLC

Practice address

1150 Maxwell Ave
Boulder, CO 80304-4185

Phone

(303) 330-6411

NPI assigned

Jun 5, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenny Ricks, M.S., CCC-SLP

Title

Sole Proprietor

Phone

(303) 330-6411

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1255567194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 8TH ST",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804011089",
            "telephone_number": "303-330-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 MAXWELL AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044185",
            "telephone_number": "303-330-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID CREW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "303-330-6411",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "12091959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pantea Khajehzadeh, MA
• Sat Tara Kaur Khalsa, L.P.C.
• Nisreen Khazaal, MD
• Lauren Khoury
• Susanne Kianicka, DR.
• Matthew Charles Kidd Jr., D.O.
• Alyssa Kidrin
• Kids Can
• Kids Spectacle Shop
• Chelsea Kilimnik, PH.D.

• Speech-Language Pathologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.