Individual ProviderKelly Leigh ThielkSocial WorkerBehavioral Health & Social Service ProvidersPractice Address300 E Horsetooth Rd Ste 200, Fort Collins, CO 80525-3154(331) 725-1878PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Leigh Thielk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1154981769Provider TypeIndividualFull NameThielk, Kelly LeighCredentialLCSW, CADCGenderFemaleSole ProprietorYesEnumeration Date6/17/2019Last Updated10/2/2019Contact InformationPractice LocationPractice Address300 E Horsetooth Rd Ste 200, Fort Collins, CO 80525-3154Phone(331) 725-1878FaxUnlisted FaxMailing LocationMailing Address3475 Yule Trail Dr, Fort Collins, CO 80524-1243Phone(331) 725-1878FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149020903IllinoisCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense32880Illinois