Provider Demographics
NPI:1639322274
Name:KESHMESHIAN, ALICE
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:KESHMESHIAN
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 1:1745 SHEA CENTER DRIVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129
Mailing Address - Country:US
Mailing Address - Phone:720-580-1060
Mailing Address - Fax:
Practice Address - Street 1:1745 SHEA CENTER DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-1537
Practice Address - Country:US
Practice Address - Phone:720-499-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health