Provider Demographics
NPI:1316368996
Name:PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC
Other - Org Name:CORRECTIONAL PSYCHOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-854-0262
Mailing Address - Street 1:3840 YORK ST
Mailing Address - Street 2:STE 230
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3536
Mailing Address - Country:US
Mailing Address - Phone:720-854-0262
Mailing Address - Fax:720-854-0263
Practice Address - Street 1:3840 YORK ST
Practice Address - Street 2:STE 230
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3536
Practice Address - Country:US
Practice Address - Phone:720-854-0262
Practice Address - Fax:720-854-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2519261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)