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General NPI Number Information
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NPI Number | 1851764393
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Entity Type | Individual
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Provider Name | DAWNELLE TILDEN MA, LAC, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 1355 S COLORADO BLVD STE C-100
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City | DENVER
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State | CO
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Zip | 80222-3305
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Country | US
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Telephone | 720-425-9039
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Fax |
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Provider Business Mailing Address
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Address Line | 2631 S NEWTON ST
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City | DENVER
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State | CO
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Zip | 80219-5744
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Country | US
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Telephone | 720-425-9039
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Fax |
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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 | 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 | ACD000448
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License Number State | CO
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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