Healthcare Provider Details

I. General information

NPI: 1144389172
Provider Name (Legal Business Name): COLORADO CENTER FOR NEUROLOGICAL REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 E ARAPAHOE ROAD SUITE 212
ENGLEWOOD CO
80112
US

IV. Provider business mailing address

7400 E ARAPAHOE ROAD SUITE 212
ENGLEWOOD CO
80112
US

V. Phone/Fax

Practice location:
  • Phone: 303-741-1077
  • Fax: 303-741-1078
Mailing address:
  • Phone: 303-741-1077
  • Fax: 303-741-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD ALLEN COOK
Title or Position: PRESIDENT CEO CLINICAL DIRECTOR
Credential: PSYD
Phone: 303-741-1077