Provider Demographics
NPI:1710043146
Name:MEADORS, CAROL (MA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MEADORS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12557
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-0557
Mailing Address - Country:US
Mailing Address - Phone:303-420-8080
Mailing Address - Fax:303-420-9299
Practice Address - Street 1:6700 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4732
Practice Address - Country:US
Practice Address - Phone:303-420-8080
Practice Address - Fax:303-420-9299
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional