Provider Demographics
NPI:1770101297
Name:O'CARROLL, CANNA (LPC)
Entity type:Individual
Prefix:
First Name:CANNA
Middle Name:
Last Name:O'CARROLL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 FAWN RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3357
Mailing Address - Country:US
Mailing Address - Phone:720-284-4538
Mailing Address - Fax:
Practice Address - Street 1:650 E. WALNUT
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107
Practice Address - Country:US
Practice Address - Phone:720-284-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health