Healthcare Provider Details

I. General information

NPI: 1285651299
Provider Name (Legal Business Name): CARRIE THERESE THRALL MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE THERESE MONELL MSW

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13225 SHADOW CANYON TRL
BROOMFIELD CO
80020-5573
US

IV. Provider business mailing address

13225 SHADOW CANYON TRL
BROOMFIELD CO
80020-5573
US

V. Phone/Fax

Practice location:
  • Phone: 303-596-8605
  • Fax:
Mailing address:
  • Phone: 303-596-8605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number937
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: