Provider Demographics
NPI:1598126120
Name:MEREDITH ELISE KURRY
Entity Type:Organization
Organization Name:MEREDITH ELISE KURRY
Other - Org Name:MEREDITH ELISE KURRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST/MENTAL HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:KURRY
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:720-231-7109
Mailing Address - Street 1:1548 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1222
Mailing Address - Country:US
Mailing Address - Phone:720-231-7109
Mailing Address - Fax:303-975-4936
Practice Address - Street 1:10090 GARRISON ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-3894
Practice Address - Country:US
Practice Address - Phone:720-231-7109
Practice Address - Fax:303-975-4936
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEREDITH ELISE KURRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992377305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization