Provider Demographics
NPI:1376851774
Name:MATSUI, NANAMI LINA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:NANAMI
Middle Name:LINA
Last Name:MATSUI
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:NANAMI
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 HORIZON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8743
Mailing Address - Country:US
Mailing Address - Phone:970-683-7035
Mailing Address - Fax:970-683-7167
Practice Address - Street 1:395 E LIONSHEAD CIR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-5354
Practice Address - Country:US
Practice Address - Phone:970-476-0930
Practice Address - Fax:970-476-0535
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000374101YA0400X
COLPC.0011245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)