Constance Lynnette Brase, M.A.
Individual provider Active NPI Counselor · Lamar, CO
NPI 1164670709 · NPPES record last updated Sep 8, 2008
Key facts
- NPI
- 1164670709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 109 Lee Ave
Suite 3
Lamar, CO 81052-3717 - Phone
- (719) 336-0478
- Fax
- (719) 384-8411
- NPI assigned
- Sep 8, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
109 Lee Ave
Suite 3
Lamar, CO 81052-3717
Mailing address
711 Barnes Ave
La Junta, CO 81050-2138
Phone (719) 384-5446
Other names
- Constance Lynette Smith
Other providers in Lamar, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.