Provider Demographics
NPI:1225692247
Name:ABENROTH, MARIE-ANNE (LPC; LAC; NCC)
Entity Type:Individual
Prefix:
First Name:MARIE-ANNE
Middle Name:
Last Name:ABENROTH
Suffix:
Gender:F
Credentials:LPC; LAC; NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N ELLICOTT HWY # A101
Mailing Address - Street 2:
Mailing Address - City:CALHAN
Mailing Address - State:CO
Mailing Address - Zip Code:80808-8877
Mailing Address - Country:US
Mailing Address - Phone:719-749-6211
Mailing Address - Fax:
Practice Address - Street 1:355 N ELLICOTT HWY # A101
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-8877
Practice Address - Country:US
Practice Address - Phone:719-749-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001850101YA0400X
COLPC.0017016101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)