Provider Demographics
NPI:1992461800
Name:THE CENTER FOR TRAUMA & RESILIENCE
Entity type:Organization
Organization Name:THE CENTER FOR TRAUMA & RESILIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TRAINING
Authorized Official - Prefix:
Authorized Official - First Name:KATHI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FANNING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-860-0660
Mailing Address - Street 1:PO BOX 18975
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-0975
Mailing Address - Country:US
Mailing Address - Phone:303-860-0660
Mailing Address - Fax:
Practice Address - Street 1:1751 N GILPIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1205
Practice Address - Country:US
Practice Address - Phone:303-860-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty