Provider Demographics
NPI:1740384114
Name:COLE, CMAUREEN (PSYD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CMAUREEN
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:PSYD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 W 6TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1880
Mailing Address - Country:US
Mailing Address - Phone:303-252-0500
Mailing Address - Fax:720-668-8954
Practice Address - Street 1:2095 W 6TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1880
Practice Address - Country:US
Practice Address - Phone:303-252-0500
Practice Address - Fax:720-668-8954
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2080103TC0700X
COPSY2080103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07020803Medicaid
CO07020803Medicaid