Provider Demographics
NPI:1588830350
Name:KEREN, ESTELLE L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ESTELLE
Middle Name:L
Last Name:KEREN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 S LOCUST ST
Mailing Address - Street 2:SUITE 219
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7126
Mailing Address - Country:US
Mailing Address - Phone:720-431-9336
Mailing Address - Fax:
Practice Address - Street 1:2755 S LOCUST ST
Practice Address - Street 2:SUITE 219
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7126
Practice Address - Country:US
Practice Address - Phone:720-431-9336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1627103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical