Provider Demographics
NPI:1639132509
Name:KING, CARRI A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CARRI
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S BLACKHAWK ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1487
Mailing Address - Country:US
Mailing Address - Phone:720-747-5584
Mailing Address - Fax:866-234-7181
Practice Address - Street 1:2121 S BLACKHAWK ST
Practice Address - Street 2:SUITE 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1487
Practice Address - Country:US
Practice Address - Phone:720-747-5584
Practice Address - Fax:866-234-7181
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53657233Medicaid