Provider Demographics
NPI:1376979716
Name:FRIESE, ARIEL (LPC)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:FRIESE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:
Other - Last Name:MINDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3030 S COLLEGE AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2557
Mailing Address - Country:US
Mailing Address - Phone:970-239-1320
Mailing Address - Fax:
Practice Address - Street 1:3030 S COLLEGE AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2557
Practice Address - Country:US
Practice Address - Phone:970-239-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11347101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000142249Medicaid