Provider Demographics
NPI:1033839154
Name:CHOO, LISA (PSYD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CHOO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15413 COOPERS HAWK CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3265
Mailing Address - Country:US
Mailing Address - Phone:303-517-4794
Mailing Address - Fax:
Practice Address - Street 1:1777 S BELLAIRE ST STE 390
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4350
Practice Address - Country:US
Practice Address - Phone:720-515-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0006272103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program