Provider Demographics
NPI:1588816565
Name:BEOHM-CHATTERTON, CARRIE (MA LPC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BEOHM-CHATTERTON
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 S MAIN ST STE 218
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5361
Mailing Address - Country:US
Mailing Address - Phone:720-277-9508
Mailing Address - Fax:
Practice Address - Street 1:6105 S MAIN ST STE 218
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5361
Practice Address - Country:US
Practice Address - Phone:720-277-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0013774101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health