Provider Demographics
NPI:1629474333
Name:STANTON-PATRICK, CAROLYN (MA, CACIII)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:STANTON-PATRICK
Suffix:
Gender:F
Credentials:MA, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3738 W PRINCETON CIR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-3110
Mailing Address - Country:US
Mailing Address - Phone:303-781-7875
Mailing Address - Fax:303-762-2196
Practice Address - Street 1:3660 W. PRINCETON CIRCLE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236
Practice Address - Country:US
Practice Address - Phone:720-283-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4886101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)