Provider Demographics
NPI:1861930588
Name:CORCORAN, BARBRA
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:
Last Name:CORCORAN
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 2270
Mailing Address - Street 2:ATTN PFS PAYER ENROLLMENT
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2270
Mailing Address - Country:US
Mailing Address - Phone:970-945-2238
Mailing Address - Fax:970-928-8926
Practice Address - Street 1:1830 BLAKE AVE STE 208
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4261
Practice Address - Country:US
Practice Address - Phone:970-945-2238
Practice Address - Fax:970-928-8926
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB0005948101YA0400X
COCSW.99257181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)