Healthcare Provider Details

I. General information

NPI: 1427879089
Provider Name (Legal Business Name): EMILY AUTRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5554 S PRINCE ST
LITTLETON CO
80120-1149
US

IV. Provider business mailing address

270 LINCOLN ST APT 203B
DENVER CO
80203-3937
US

V. Phone/Fax

Practice location:
  • Phone: 720-449-6673
  • Fax:
Mailing address:
  • Phone: 479-462-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0009926880
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: