Provider Demographics
NPI:1700565827
Name:JUDE, KARIANA
Entity Type:Individual
Prefix:
First Name:KARIANA
Middle Name:
Last Name:JUDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 S TRENTON WAY APT 13-102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-7003
Mailing Address - Country:US
Mailing Address - Phone:304-767-1231
Mailing Address - Fax:
Practice Address - Street 1:1660 S ALBION ST STE 425
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4043
Practice Address - Country:US
Practice Address - Phone:720-531-3917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health