MEDICARE: NINA M CAMPANIELLO LPCC-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPCC.0018875	CO

General Provider Information

NPI Number	:	1033840848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA M CAMPANIELLO LPCC-C

Provider Business Mailing Address
First Line	:	9725 E HAMPDEN AVE STE 400
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-4919
Country	:	US
Telephone Number	:	303-504-6188
Fax Number	:

Provider Business Practice Location Address
First Line	:	9725 E HAMPDEN AVE STE 400
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-4919
Country	:	US
Telephone Number	:	303-504-6188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	06/22/2022

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