Provider Demographics
NPI:1619315462
Name:COLORADO COUNSELING GROUP, LLC
Entity Type:Organization
Organization Name:COLORADO COUNSELING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIRULLI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-903-4305
Mailing Address - Street 1:PO BOX 102343
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-2343
Mailing Address - Country:US
Mailing Address - Phone:303-903-4305
Mailing Address - Fax:
Practice Address - Street 1:1440 BLAKE ST
Practice Address - Street 2:330
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1474
Practice Address - Country:US
Practice Address - Phone:303-903-4305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3333103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty