Individual
TARO AUGUSTUS KURUSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6541 SPECKER AVE, FORT CARSON, CO 80913-4263
(719) 526-7155
Mailing address
6541 SPECKER AVE, FORT CARSON, CO 80913-4263
(719) 526-7155
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY8365
FL
103TC1900X
Counseling Psychologist
2316
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4039014
BLUE CROSS BLUE SHIELD
—
01
—
4065356
BCBS-TN
—
01
—
476464000
MAGELLAN
—
01
—
680014816
RAILROAD MEDICARE
—
01
—
702017316
CARITEN HEALTHCARE
—
01
—
TN0102
JOHNDEERE HEALTHCARE
—
Enumeration date
12/02/2005
Last updated
09/26/2022
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