1578755005 NPI number — PRAI COUNSELING SERVICES INC

Table of content: (NPI 1578755005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578755005 NPI number — PRAI COUNSELING SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRAI COUNSELING SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578755005
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8671 WOLFF CT
Provider Second Line Business Mailing Address:
STE 220
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80031-3609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-359-3358
Provider Business Mailing Address Fax Number:
303-410-2607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8753 YATES DR
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80031-6947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-359-3358
Provider Business Practice Location Address Fax Number:
303-426-6027
Provider Enumeration Date:
08/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PRAI
Authorized Official First Name:
DULCINEA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
LICENSED CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
303-359-3358

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  CSW-346 , 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)

  • Identifier: CSW-346 . This is a "CLINICAL SOCIAL WORKER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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