Provider Demographics
NPI:1174283303
Name:MERRILL, CHARLOTTE OLIVIA (LPCC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:OLIVIA
Last Name:MERRILL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10097 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6656
Mailing Address - Country:US
Mailing Address - Phone:303-947-1684
Mailing Address - Fax:
Practice Address - Street 1:1942 BROADWAY STE 314C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5233
Practice Address - Country:US
Practice Address - Phone:720-505-3312
Practice Address - Fax:877-585-5187
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019786101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional