Provider Demographics
NPI:1366756199
Name:VAN HORNE, CORRIE ELIZABETH (MA, LPC, RD)
Entity type:Individual
Prefix:MRS
First Name:CORRIE
Middle Name:ELIZABETH
Last Name:VAN HORNE
Suffix:
Gender:F
Credentials:MA, LPC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N GRANT ST STE 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2987
Mailing Address - Country:US
Mailing Address - Phone:303-709-2404
Mailing Address - Fax:
Practice Address - Street 1:800 N GRANT ST STE 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2987
Practice Address - Country:US
Practice Address - Phone:303-709-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS961321133V00000X
CO0015918101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered