Provider Demographics
NPI:1053197020
Name:MCLERRAN, CARI
Entity type:Individual
Prefix:MRS
First Name:CARI
Middle Name:
Last Name:MCLERRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:CO
Mailing Address - Zip Code:80614-0506
Mailing Address - Country:US
Mailing Address - Phone:720-772-9007
Mailing Address - Fax:
Practice Address - Street 1:4171 E 115TH PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-2676
Practice Address - Country:US
Practice Address - Phone:720-772-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional