Provider Demographics
NPI:1316223373
Name:LENTINE, CORINNE D
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:D
Last Name:LENTINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CORI
Other - Middle Name:D
Other - Last Name:LENTINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10055 SEDALIA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-8864
Mailing Address - Country:US
Mailing Address - Phone:303-475-6716
Mailing Address - Fax:
Practice Address - Street 1:10055 SEDALIA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-8864
Practice Address - Country:US
Practice Address - Phone:303-475-6716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health