Provider Demographics
NPI:1841570702
Name:CARR, TODD ROBERT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ROBERT
Last Name:CARR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GARDEN CTR
Mailing Address - Street 2:#16
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-7087
Mailing Address - Country:US
Mailing Address - Phone:303-960-8095
Mailing Address - Fax:
Practice Address - Street 1:80 GARDEN CTR
Practice Address - Street 2:#16
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7087
Practice Address - Country:US
Practice Address - Phone:303-960-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004139103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist