MEDICARE: DONNA NAZARCHYK MSC, BCBA, LPC

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
1	101Y00000X	Counselor	LPC.0016376	CO
2	101YM0800X	Mental Health Counselor	MHC-655	HI
3	103K00000X	Behavior Analyst
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1790021640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA NAZARCHYK MSC, BCBA, LPC

Provider Business Mailing Address
First Line	:	21699 E QUINCY AVE UNIT F282
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-2884
Country	:	US
Telephone Number	:	808-234-4436
Fax Number	:

Provider Business Practice Location Address
First Line	:	21699 E QUINCY AVE UNIT F282
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-2884
Country	:	US
Telephone Number	:	808-234-4436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	01/30/2023

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