Provider Demographics
NPI:1831597244
Name:PRAIRIE, ANNEMARIE CURRAN (MA, LPC, CAC III)
Entity type:Individual
Prefix:MS
First Name:ANNEMARIE
Middle Name:CURRAN
Last Name:PRAIRIE
Suffix:
Gender:F
Credentials:MA, LPC, CAC III
Other - Prefix:MS
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:CURRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1049 DEARBORN PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303
Mailing Address - Country:US
Mailing Address - Phone:720-331-6928
Mailing Address - Fax:
Practice Address - Street 1:2505 WALNUT ST.
Practice Address - Street 2:STE 303
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302
Practice Address - Country:US
Practice Address - Phone:720-331-6928
Practice Address - Fax:303-736-6807
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007209101YA0400X
CO0005709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional