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NPI Code Detail

MEDICARE: MRS. JUDITH CASS HALLORAN LPC

MEDICARE: MRS. JUDITH CASS HALLORAN LPC
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
1101YM0800XMental Health Counselor4508CO

General Provider Information

NPI Number : 1710036132
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDITH CASS HALLORAN LPC
Provider Business Mailing Address
First Line : 2641 BETTS CIR
Second Line :
City : ERIE
State : CO
Zip : 80516-7518
Country : US
Telephone Number : 303-522-9509
Fax Number :
Provider Business Practice Location Address
First Line : 1501 YARMOUTH AVE
Second Line :
City : BOULDER
State : CO
Zip : 80304-0564
Country : US
Telephone Number : 303-786-9314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 01/07/2015

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