Provider Demographics
NPI:1275611329
Name:CANYON BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CANYON BEHAVIORAL HEALTH
Other - Org Name:COLORADO COUNSELING PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-430-4010
Mailing Address - Street 1:8670 WOLFF CT
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6956
Mailing Address - Country:US
Mailing Address - Phone:303-430-4010
Mailing Address - Fax:303-430-5306
Practice Address - Street 1:8670 WOLFF CT
Practice Address - Street 2:SUITE 130
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6956
Practice Address - Country:US
Practice Address - Phone:303-430-4010
Practice Address - Fax:303-430-5306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty