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General NPI Number Information
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NPI Number | 1902353568
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Entity Type | Individual
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Provider Name | HOLLY CARPENTER
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1410 VANCE ST
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City | LAKEWOOD
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State | CO
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Zip | 80214
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Country | US
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Telephone | 303-467-2624
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 VANCE ST SUITE 200
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City | LAKEWOOD
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State | CO
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Zip | 80214-5299
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Country | US
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Telephone | 303-467-2624
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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 | NLC0104865
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License Number State | CO
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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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