Stephanie Addiss
Individual provider Active NPI Mental Health Counselor · Boulder, CO
NPI 1982249678 · NPPES record last updated Nov 17, 2019
Key facts
- NPI
- 1982249678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC.0012081 (CO)
- Practice address
- 2429 Broadway St
Boulder, CO 80304-4108 - Phone
- (949) 241-2220
- NPI assigned
- Nov 17, 2019
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.0012081 | CO | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC.0012081 | CO | Yes |
Addresses
Primary practice location
2429 Broadway St
Boulder, CO 80304-4108
Mailing address
2429 Broadway St
Boulder, CO 80304-4108
Other providers in Boulder, CO
- Julisa Danae Adams
- Melanie Adams
- Susan Virginia Adams
- Tara Adams
- Luke Addington
- Reuben Addo
- Arielle Ades
- Adh Boulder PLLC
- Adio Health Chiropractic
- Aaron Sherman Adler
All providers in Boulder, CO · Mental Health Counselor in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2019. 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.