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NPI Code Detail

MEDICARE: JAMES THIELENS III LAC, LPCC

MEDICARE: JAMES THIELENS III LAC, LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorLPCC.0021797CO
2101YA0400XAddiction (Substance Use Disorder) CounselorACD.0002414CO

General Provider Information

NPI Number : 1417775065
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES THIELENS III LAC, LPCC
Provider Business Mailing Address
First Line : 4100 W 38TH AVE STE B
Second Line :
City : DENVER
State : CO
Zip : 80212-1978
Country : US
Telephone Number : 970-232-8909
Fax Number :
Provider Business Practice Location Address
First Line : 4100 W 38TH AVE STE B
Second Line :
City : DENVER
State : CO
Zip : 80212-1978
Country : US
Telephone Number : 970-232-8909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2024
Last Update Date : 10/02/2024

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