Provider Demographics
NPI:1134337538
Name:GEIST, CAROL A
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:GEIST
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:A
Other - Last Name:MATOWK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3341 BIG BND
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6279
Mailing Address - Country:US
Mailing Address - Phone:720-652-9545
Mailing Address - Fax:
Practice Address - Street 1:2833 BROADWAY ST
Practice Address - Street 2:CARE OF WARNER HOUSE
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3544
Practice Address - Country:US
Practice Address - Phone:303-449-2217
Practice Address - Fax:303-786-9247
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor