| Fearlessly Authentic Psychology, Llc | |
|
777 S Wadsworth Blvd Ste 102 Lakewood CO 80226-4300 | |
| (913) 208-4241 | |
| Not Available |
| Full Name | Fearlessly Authentic Psychology, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 777 S Wadsworth Blvd Ste 102, Lakewood, Colorado |
| Authorized Official Name and Position | Kimberly Garrison (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9132084241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fearlessly Authentic Psychology, Llc 332 S Carr St Lakewood CO 80226-3015 Ph: (913) 208-4241 | Fearlessly Authentic Psychology, Llc 777 S Wadsworth Blvd Ste 102 Lakewood CO 80226-4300 Ph: (913) 208-4241 |
| NPI Number | 1780312298 |
|---|---|
| Provider Enumeration Date | 08/11/2022 |
| Last Update Date | 08/16/2022 |
| Certification Date | 08/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780312298 | NPI | - | NPPES |
| 1992011373 | Other | CO | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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