Dominique Condevaux, LAC, LPC, MAC, NCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ACD.0000219 Issued in CO

Practice address

12101 E 2ND Ave
Suite 201B
Aurora, CO 80011-8327

Phone

(303) 819-7788

Fax

(720) 216-0273

NPI assigned

Jan 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1093010647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 E 2ND AVE",
            "address_2": "SUITE 201B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118327",
            "telephone_number": "303-819-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 E 2ND AVE",
            "address_2": "SUITE 201B",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800118327",
            "telephone_number": "303-819-7788",
            "fax_number": "720-216-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDEVAUX",
        "first_name": "DOMINIQUE",
        "credential": "LAC, LPC, MAC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000219",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0011288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Steven Conard, MD
• Tyre Marie Concagh, PA-C
• Kyle F Concannon, MD
• Concepts Counseling and Psychotherapy
• Concise Chiropractic LLC
• Kristine Condie
• Ginny Cone
• Conexion Counseling Services LLC
• Congregation of Sisters of Charity
• Imani Conley-Frazier

• Addiction (Substance Use Disorder) Counselor in Aurora, CO
• Providers in Aurora, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.