DR. KERRY LYN GAGNON (NPI# 1679056741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679056741 |
| Entity Type | Individual |
| Full Name | DR. KERRY LYN GAGNON |
| Credential | PHD |
| Practice Address |
11059 E Bethany Dr Aurora CO 80014-2622 |
| Practice Telephone | 3036172300 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
11059 E BETHANY DR |
| City | AURORA |
| State | CO |
| Zip Code | 80014-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487654463 | Marc Paul Goodman | Psychiatry & Neurology | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2005-07-29 |
| 1699311605 | Angelica Halbert | Counselor | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-11-25 |
| 1639714231 | Sharon Elaine Bonds | Case Manager/Care Coordinator | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-11-07 |
| 1598308603 | Salia R Thomas | Case Manager/Care Coordinator | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-10-21 |
| 1467002022 | Ashley Martin | Student in an Organized Health Care Education/Training Program | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-09-16 |
| 1013561612 | Ashley Rose Dryer | Counselor | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-07-31 |
| 1295389096 | Elizabeth Healy | Counselor | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-07-30 |
| 1326692526 | Celia Pope | Counselor | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-07-26 |
| 1710546841 | Ana Rosa Saucedo Lopez | Case Manager/Care Coordinator | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-06-12 |
| 1780240853 | Emily Carlson | Case Manager/Care Coordinator | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2019-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825021 | Dieuvil Varice | Occupational Therapist | 2851 S Parker Rd Ste 570, Aurora, Co, Aurora, CO 80014 | 2020-06-14 |
| 1518437144 | Curtis E Redd | Case Manager/Care Coordinator | 1059 E Bethany Dr, Suite 200, Aurora, CO 80014 | 2018-11-27 |
| 1144795154 | Prestige Adult Day Care LLC | Clinic/Center | 2860 S Havana St, Unit C, Aurora, CO 80014 | 2018-10-05 |
| 1609375492 | Jacob Mcbride | Behavior Technician | 2121 S Blackhawk St 100, Aurora, CO 80014 | 2018-02-07 |
| 1265931240 | Jasmine Nicole Joseph | Behavior Technician | 2121 S. Blackhawk St., Aurora, CO 80014 | 2018-02-06 |
| 1255830238 | Russel Talukder | Behavioral Analyst | 2121 South Blackhawk St 100, Aurora, CO 80014 | 2018-02-06 |
| 1467951442 | Dylan Kelley | Behavior Technician | 2121 Blackhawk St. Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1184123168 | Talisa Fisher | Behavior Technician | 2121 S Blackhawk St Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1144732314 | Hellen A Noamesi | Registered Nurse | Kaiser Water Park 1, 2500 S. Havana St, Aurora, CO 80014 | 2017-10-27 |
| 1255840641 | Amanda Dawn Thompson | Massage Therapist | 3035 South Parker Rd., 560 Building E, Aurora, CO 80014 | 2017-09-28 |
| Find all providers in zip 80014 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699217778 | Bradley Kent Jackson | Psychologist | 13123 E 16th Ave # 245, Aurora, CO 80045-7106 | 2016-11-07 |
| 1811301153 | Rachel Ahern | Psychologist | 1298 Peoria St, Aurora, CO 80011-6206 | 2014-06-15 |
| 1275856890 | Idalia Massa | Psychologist | 12631 E 17th Ave Rm 3408, Blg: Ao1, Ms: F406, Uc School of Medicine, Aurora, CO 80045-2527 | 2010-03-10 |
| 1851546394 | Ashley Danner Sward | Psychologist | 13001 E 17th Ave Fl 2, Aurora, CO 80045-2505 | 2008-11-25 |
| 1447800859 | Layla Leilani Schimmel | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-09-17 |
| 1881247401 | Courtney Lynn | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-07-23 |
| 1326509738 | Michelle Clementi | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2019-03-28 |
| 1851886584 | Catherine Naclerio | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2018-06-25 |
| 1679083992 | Alexandra Ament | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-10-02 |
| 1326564428 | Catherine Wolcott | Psychologist | 13123 E 16th Ave, Aurora, CO 80045-7106 | 2017-08-21 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.