Provider Demographics
NPI:1215334511
Name:JODY KIRCHER, PSYD, LLC
Entity type:Organization
Organization Name:JODY KIRCHER, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:DRAPER
Authorized Official - Last Name:KIRCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-862-2501
Mailing Address - Street 1:9085 E MINERAL CIR
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3462
Mailing Address - Country:US
Mailing Address - Phone:303-862-2501
Mailing Address - Fax:720-482-6213
Practice Address - Street 1:9085 E MINERAL CIR
Practice Address - Street 2:SUITE 235
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3462
Practice Address - Country:US
Practice Address - Phone:303-862-2501
Practice Address - Fax:720-482-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY-3083103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty