MEDICARE: CHARITY RAULS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor	LPC.0014151	CO

General Provider Information

NPI Number	:	1396134805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY RAULS

Provider Business Mailing Address
First Line	:	155 INVERNESS DR W STE 200
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80112-5000
Country	:	US
Telephone Number	:	303-730-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 W BERRY AVE
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-1101
Country	:	US
Telephone Number	:	303-597-3967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2015
Last Update Date	:	11/17/2017

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Directions to “ CHARITY RAULS ” Practice Location

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