Provider Demographics
NPI:1790345825
Name:PAULA MOORE
Entity Type:Organization
Organization Name:PAULA MOORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:303-809-1704
Mailing Address - Street 1:7600 LANDMARK WAY UNIT 701
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1963
Mailing Address - Country:US
Mailing Address - Phone:303-809-1704
Mailing Address - Fax:
Practice Address - Street 1:1777 S HARRISON ST STE 1200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3955
Practice Address - Country:US
Practice Address - Phone:303-809-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty