Healthcare Provider Details

I. General information

NPI: 1942118971
Provider Name (Legal Business Name): MARCI AMRINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E MAPLE ST
LAMAR CO
81052-2540
US

IV. Provider business mailing address

800 E MAPLE ST
LAMAR CO
81052-2540
US

V. Phone/Fax

Practice location:
  • Phone: 970-466-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACC.0021113
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: