Provider Demographics
NPI:1437700911
Name:TMS OF CHERRY CREEK, LLC
Entity Type:Organization
Organization Name:TMS OF CHERRY CREEK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-393-1726
Mailing Address - Street 1:52 MONROE ST STE B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5669
Mailing Address - Country:US
Mailing Address - Phone:303-393-1726
Mailing Address - Fax:303-200-9009
Practice Address - Street 1:52 MONROE ST STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5669
Practice Address - Country:US
Practice Address - Phone:303-393-1726
Practice Address - Fax:303-200-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1912336041OtherMD