Provider Demographics
NPI:1225385040
Name:GOFFREDI, ALICIA (PSYD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:GOFFREDI
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 1:2424 W CAITHNESS PL
Mailing Address - Street 2:#124
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3772
Mailing Address - Country:US
Mailing Address - Phone:720-470-0010
Mailing Address - Fax:303-200-7098
Practice Address - Street 1:950 S CHERRY ST
Practice Address - Street 2:STE 1010
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2699
Practice Address - Country:US
Practice Address - Phone:303-771-0861
Practice Address - Fax:720-889-4258
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical