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General NPI Number Information
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NPI Number | 1306979968
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Entity Type | Individual
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Provider Name | PETRA ULRYCH LPC
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 2100 N BROADWAY
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City | DENVER
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State | CO
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Zip | 80205-2526
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Country | US
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Telephone | 303-312-9822
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Fax | 303-322-5149
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Provider Business Mailing Address
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Address Line | 1585 LEYDEN ST
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City | DENVER
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State | CO
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Zip | 80220-1619
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Country | US
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Telephone | 720-878-3548
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Fax | 720-815-3892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-5653
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LPC-5653
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-5653
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License Number State | CO
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