Healthcare Provider Details

I. General information

NPI: 1407324833
Provider Name (Legal Business Name): DIANA LYNN BASQUEZ MA, LPCC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2018
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 WADSWORTH BLVD
WHEAT RIDGE CO
80033-4609
US

IV. Provider business mailing address

6935 W 16TH AVE
LAKEWOOD CO
80214-5303
US

V. Phone/Fax

Practice location:
  • Phone: 303-242-2233
  • Fax:
Mailing address:
  • Phone: 303-242-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number19-322
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0015703
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: