Provider Demographics
NPI:1285905406
Name:MEGGINSON, RALPH LYNWOOD (CACII)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:LYNWOOD
Last Name:MEGGINSON
Suffix:
Gender:M
Credentials:CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-3632
Mailing Address - Country:US
Mailing Address - Phone:303-436-3500
Mailing Address - Fax:
Practice Address - Street 1:1155 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3632
Practice Address - Country:US
Practice Address - Phone:303-436-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7480101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO164525Medicaid