Provider Demographics
NPI:1588794150
Name:TIMMONS, KAREN JEANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:JEANNE
Last Name:TIMMONS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3808
Mailing Address - Country:US
Mailing Address - Phone:303-329-3324
Mailing Address - Fax:303-377-6454
Practice Address - Street 1:155 SOUTH MADISON STREET
Practice Address - Street 2:SUITE #332
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3069
Practice Address - Country:US
Practice Address - Phone:303-329-3324
Practice Address - Fax:303-377-6454
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1290103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1290OtherPSYCHOLOGY LICENSE
92656Medicare ID - Type Unspecified