Provider Demographics
NPI:1598295933
Name:HESTER-MCCULLOUGH, EMILY TRIPP
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:TRIPP
Last Name:HESTER-MCCULLOUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11845 RIDGE PKWY APT 1221
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6510
Mailing Address - Country:US
Mailing Address - Phone:425-223-8317
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST STE 530
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2554
Practice Address - Country:US
Practice Address - Phone:720-863-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60756989101YM0800X
WALH61084778101YM0800X
COLPC0016661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health