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General NPI Number Information
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NPI Number | 1154603819
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Entity Type | Organization
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Legal Business Name | ROBYN PETERS
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 517 BIG THOMPSON AVE SUITE 120
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City | ESTES PARK
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State | CO
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Zip | 80517-9661
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Country | US
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Telephone | 970-586-6400
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Fax | 970-586-6400
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Provider Business Mailing Address
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Address Line | PO BOX 1846
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City | ESTES PARK
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State | CO
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Zip | 80517-1846
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Country | US
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Telephone | 970-586-8400
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Fax | 970-586-8400
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Authorized Official
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Title or Position | OWNER
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Name | ROBYN PETERS
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Credential | LPC, MS, MED
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Telephone | 970-586-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACC-3175
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC-465
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License Number State | CO
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