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NPI Code Detail

MEDICARE: ELIZABETH WYNN LPC

MEDICARE: ELIZABETH WYNN LPC
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
1101YM0800XMental Health Counselor.0023211CO

General Provider Information

NPI Number : 1093670036
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH WYNN LPC
Provider Business Mailing Address
First Line : 9364 TEDDY LN STE 204
Second Line :
City : LONE TREE
State : CO
Zip : 80124-2873
Country : US
Telephone Number : 303-656-1154
Fax Number : 303-656-1154
Provider Business Practice Location Address
First Line : 9364 TEDDY LN STE 204
Second Line :
City : LONE TREE
State : CO
Zip : 80124-2873
Country : US
Telephone Number : 303-656-1154
Fax Number : 303-656-1154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2025
Last Update Date : 12/22/2025

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