Healthcare Provider Details

I. General information

NPI: 1730892019
Provider Name (Legal Business Name): ALISHA M ADRIAN LPC0011272
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 01/02/2023
Certification Date: 01/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4979 4200 RD
CRAWFORD CO
81415-9178
US

IV. Provider business mailing address

4979 4200 RD
CRAWFORD CO
81415-9178
US

V. Phone/Fax

Practice location:
  • Phone: 303-859-7385
  • Fax: 970-921-5420
Mailing address:
  • Phone: 303-859-7385
  • Fax: 970-921-5420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0011272
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: