Provider Demographics
NPI:1285031815
Name:SANCHEZ, SELENA (PSY-C, LAC)
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PSY-C, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 CHAMBERS RD STE E
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5920
Mailing Address - Country:US
Mailing Address - Phone:303-340-8990
Mailing Address - Fax:
Practice Address - Street 1:9351 GRANT ST STE 560
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4373
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001013101YA0400X
COPSYC.00015188103TC1900X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling