Provider Demographics
NPI:1548328032
Name:CORY, CONNIE C (MA LPC)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:C
Last Name:CORY
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:C
Other - Last Name:CORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LPC
Mailing Address - Street 1:50 S STEELE ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-388-4695
Mailing Address - Fax:720-747-0800
Practice Address - Street 1:50 S STEELE ST
Practice Address - Street 2:SUITE 810
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:303-388-4695
Practice Address - Fax:720-747-0800
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO998103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service