MEDICARE: LOUANN R HILLESLAND MA,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
1	101Y00000X	Counselor	4615	CO
2	101YM0800X	Mental Health Counselor	4615	CO
3	101YP2500X	Professional Counselor	4615	CO

General Provider Information

NPI Number	:	1528200383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUANN R HILLESLAND MA,LPC

Provider Business Mailing Address
First Line	:	7200 E DRY CREEK RD
Second Line	:	B-102
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-2537
Country	:	US
Telephone Number	:	303-721-0005
Fax Number	:	720-851-6823

Provider Business Practice Location Address
First Line	:	7200 E DRY CREEK RD
Second Line	:	B-102
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-2537
Country	:	US
Telephone Number	:	303-721-0005
Fax Number	:	720-851-6823

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

Provider Enumeration Date	:	03/25/2009
Last Update Date	:	03/25/2009

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