Healthcare Provider Details

I. General information

NPI: 1285146878
Provider Name (Legal Business Name): VINCENT PERRONE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3426 CRIPPLE CREEK SQ
BOULDER CO
80305-7125
US

IV. Provider business mailing address

3426 CRIPPLE CREEK SQ
BOULDER CO
80305-7125
US

V. Phone/Fax

Practice location:
  • Phone: 914-755-9824
  • Fax:
Mailing address:
  • Phone: 914-755-9824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0015691
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0016175
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: