MEDICARE: ALICE KESHMESHIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1639322274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE KESHMESHIAN

Provider Business Mailing Address
First Line	:	1745 SHEA CENTER DRIVE
Second Line	:	4TH FLOOR
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129
Country	:	US
Telephone Number	:	720-580-1060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1745 SHEA CENTER DR
Second Line	:	4TH FLOOR
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-1537
Country	:	US
Telephone Number	:	720-499-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	04/29/2016

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Directions to “ ALICE KESHMESHIAN ” Practice Location

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