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General NPI Number Information
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NPI Number | 1396415501
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Entity Type | Organization
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Legal Business Name | THECOOLLINEORG
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Dates
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Enumeration Date | 09/18/2021
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 12157 W CEDAR DR STE 202
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City | LAKEWOOD
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State | CO
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Zip | 80228-2100
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Country | US
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Telephone | 303-357-9743
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Fax | 303-985-7882
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Provider Business Mailing Address
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Address Line | 3027 KNOLLS END DR UNIT 5
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City | FORT COLLINS
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State | CO
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Zip | 80526-5827
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Country | US
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Telephone | 303-357-9743
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Fax | 303-985-7882
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Authorized Official
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Title or Position | FOUNDER, EXEC. DIRECTOR, THERAPIST
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Name | DR. PAULA R CANNON GABLE
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Credential | LMFT, ADDC
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Telephone | 303-357-9743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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