Provider Demographics
NPI:1114709342
Name:GARNER, JOHN BRIAN (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRIAN
Last Name:GARNER
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9039 SMOKE SIGNAL WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-3038
Mailing Address - Country:US
Mailing Address - Phone:970-632-2362
Mailing Address - Fax:
Practice Address - Street 1:9039 SMOKE SIGNAL WAY
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80549-3038
Practice Address - Country:US
Practice Address - Phone:970-632-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000806101YA0400X
COLPC.0013450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)