Provider Demographics
NPI:1346337276
Name:BRENNAN, BONNIE M (MA, LPC, CEDS)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:M
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MA, LPC, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25587 CONIFER RD STE 105-115
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9067
Mailing Address - Country:US
Mailing Address - Phone:720-663-8699
Mailing Address - Fax:
Practice Address - Street 1:607 10TH ST STE 104
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1053
Practice Address - Country:US
Practice Address - Phone:720-663-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional