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General NPI Number Information
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NPI Number | 1750746350
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Entity Type | Organization
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Legal Business Name | COLORADO INSTITUTE FOR CONTEMPORARY PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 6795 E TENNESSEE AVE STE 432
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City | DENVER
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State | CO
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Zip | 80224-1659
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Country | US
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Telephone | 303-264-7946
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Fax | 303-474-9460
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Provider Business Mailing Address
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Address Line | 6795 E TENNESSEE AVE STE 432
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City | DENVER
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State | CO
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Zip | 80224-1659
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Country | US
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Telephone | 303-264-7946
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Fax | 303-474-9460
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Authorized Official
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Title or Position | CEO
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Name | ANDREW A MOROZOV
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Credential | PHD, LCSW
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Telephone | 303-264-7946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09924107
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License Number State | CO
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