Individual
MS. JUTHARAT MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RN, CAC III
Contact information
Practice address
2610 STOUT ST, DENVER, CO 80205-2941
(303) 504-1200
Mailing address
2610 STOUT ST, DENVER, CO 80205-2941
(720) 341-8694
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7138
CO
101YP2500X
Professional Counselor
6391
CO
163W00000X
Registered Nurse
162465
CO
Other
Enumeration date
06/11/2007
Last updated
07/16/2012
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