Provider Demographics
NPI:1053850677
Name:FAY, KAREN (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 10TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5817
Mailing Address - Country:US
Mailing Address - Phone:303-273-9830
Mailing Address - Fax:
Practice Address - Street 1:607 10TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5817
Practice Address - Country:US
Practice Address - Phone:303-273-9830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2579103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical