Provider Demographics
NPI:1154732006
Name:THE AFDA GROUP, INC.
Entity type:Organization
Organization Name:THE AFDA GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SHARON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:303-796-7004
Mailing Address - Street 1:6162 S KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4235
Mailing Address - Country:US
Mailing Address - Phone:303-796-7004
Mailing Address - Fax:303-796-8777
Practice Address - Street 1:6162 S KEARNEY ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4235
Practice Address - Country:US
Practice Address - Phone:303-796-7004
Practice Address - Fax:303-796-8777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE AFDA GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1386717239OtherNPI