=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467998351
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LA CLINICA DE ESPERANZA, LLC (PRIVATE PRACTICE)
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2017
-----------------------------------------------------
Last Update Date | 10/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 225 UNION BLVD STE 150
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80228-1826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-280-7063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 UNION BLVD STE 150
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80228-1826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-280-7063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NANCY ANN GUNZNER
-----------------------------------------------------
Credential | LMFT, LAC, EMDR
-----------------------------------------------------
Telephone | 720-280-7063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | ACB.0007312
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFT.0001284
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------