Healthcare Provider Details

I. General information

NPI: 1366367484
Provider Name (Legal Business Name): ADELLA GONZALEZ LPC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 1ST AVE
BROOMFIELD CO
80020-2279
US

IV. Provider business mailing address

1000 W 1ST AVE
BROOMFIELD CO
80020-2279
US

V. Phone/Fax

Practice location:
  • Phone: 303-802-6808
  • Fax:
Mailing address:
  • Phone: 303-802-6808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC0025261
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: