Healthcare Provider Details

I. General information

NPI: 1134136831
Provider Name (Legal Business Name): CAROL OLIVIA LOADMAN-COPELAND PH.D., N.C.C., R.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROL OLIVIA COPELAND PH.D.

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 E ARAPAHOE RD STE 203
CENTENNIAL CO
80112
US

IV. Provider business mailing address

7600 E ARAPAHOE RD STE 203
CENTENNIAL CO
80112-1260
US

V. Phone/Fax

Practice location:
  • Phone: 303-771-0449
  • Fax: 720-708-3074
Mailing address:
  • Phone: 303-771-0449
  • Fax: 720-708-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005532L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2658
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2658
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2658
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: