Provider Demographics
NPI:1033216700
Name:LAUGHLIN, LOREN A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:A
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:KANARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 KALISA WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3508
Mailing Address - Country:US
Mailing Address - Phone:888-948-6789
Mailing Address - Fax:877-345-3501
Practice Address - Street 1:9220 TEDDY LN STE 1000D
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6756
Practice Address - Country:US
Practice Address - Phone:720-772-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2805103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67476350Medicaid
COPSY.0002805OtherPROFESSIONAL LICENSE
CO11945177OtherCAQH PIN
COCOB4010Medicare PIN