Healthcare Provider Details

I. General information

NPI: 1841155991
Provider Name (Legal Business Name): CHERIE COUVILLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 OLD POST OFFICE RD
BOULDER CO
80302-9279
US

IV. Provider business mailing address

223 OLD POST OFFICE RD
BOULDER CO
80302-9279
US

V. Phone/Fax

Practice location:
  • Phone: 720-491-1676
  • Fax:
Mailing address:
  • Phone: 720-491-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0023275
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: