Provider Demographics
NPI:1073715405
Name:ARMSTRONG, MARNI GWEN (MA, LPC, NCC, ADS)
Entity Type:Individual
Prefix:MS
First Name:MARNI
Middle Name:GWEN
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MA, LPC, NCC, ADS
Other - Prefix:MS
Other - First Name:MARNI
Other - Middle Name:GWEN
Other - Last Name:SPUHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC, ADS
Mailing Address - Street 1:1922 PAYTON CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-1327
Mailing Address - Country:US
Mailing Address - Phone:719-591-5307
Mailing Address - Fax:
Practice Address - Street 1:3585 VAN TEYLINGEN DR STE A
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917
Practice Address - Country:US
Practice Address - Phone:719-331-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC 9249101YP2500X
COLPC.0005086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO866781Medicaid