Provider Demographics
NPI:1023446572
Name:CHILD AND ADOLESCENT BEHAVIORAL SUPPORTS
Entity type:Organization
Organization Name:CHILD AND ADOLESCENT BEHAVIORAL SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-660-5397
Mailing Address - Street 1:7200 E DRY CREEK RD
Mailing Address - Street 2:SUITE E-207
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2537
Mailing Address - Country:US
Mailing Address - Phone:303-660-5397
Mailing Address - Fax:303-660-5397
Practice Address - Street 1:7200 E DRY CREEK RD
Practice Address - Street 2:SUITE E-207
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2537
Practice Address - Country:US
Practice Address - Phone:303-660-5397
Practice Address - Fax:303-660-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-20
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012608101YP2500X
CO2050103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty