Provider Demographics
NPI:1437529609
Name:COLORADO CHILDREN'S THERAPY
Entity Type:Organization
Organization Name:COLORADO CHILDREN'S THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-460-7372
Mailing Address - Street 1:100 WHITNEY CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-6132
Mailing Address - Country:US
Mailing Address - Phone:970-460-7372
Mailing Address - Fax:
Practice Address - Street 1:100 WHITNEY CT
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-6132
Practice Address - Country:US
Practice Address - Phone:970-460-7372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-17569103K00000X
COSLP.0001686235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72058749Medicaid