Basic Information
| Provider Information | |||||||||
| NPI: | 1144365842 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASNER | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | TIMPONE | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | BS, CAC III | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PURDIE | ||||||||
| OtherFirstName: | CRAIG | ||||||||
| OtherMiddleName: | CASNER | ||||||||
| OtherNamePrefix: | MR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2109 E 16TH AVE APT 1 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802061169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035041800 | ||||||||
| FaxNumber: | 3035041815 | ||||||||
| Practice Location | |||||||||
| Address1: | 1634 DOWNING ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035041800 | ||||||||
| FaxNumber: | 3035041815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.