Provider Demographics
NPI:1770817025
Name:COGLEY, JOHN (MDIV, CCFC, ADVTP)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:COGLEY
Suffix:
Gender:M
Credentials:MDIV, CCFC, ADVTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S HAVANA ST
Mailing Address - Street 2:SUITE #712
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4018
Mailing Address - Country:US
Mailing Address - Phone:303-337-4808
Mailing Address - Fax:303-337-5087
Practice Address - Street 1:1450 S HAVANA ST
Practice Address - Street 2:SUITE #712
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4018
Practice Address - Country:US
Practice Address - Phone:303-337-4808
Practice Address - Fax:303-337-5087
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP1600X, 103TB0200X, 103TC1900X, 103TF0200X, 103TP2701X
CONLC448 DOC APPROVED103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy