Provider Demographics
NPI:1215054655
Name:CALABRESE, AMY (PSYD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:GORSLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7829 E 28TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2435
Mailing Address - Country:US
Mailing Address - Phone:303-746-7478
Mailing Address - Fax:
Practice Address - Street 1:673 GRANT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3506
Practice Address - Country:US
Practice Address - Phone:303-831-0505
Practice Address - Fax:303-860-0970
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2628103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803149Medicare ID - Type UnspecifiedGROUP
CO803150Medicare ID - Type UnspecifiedINDIVIDUAL