Provider Demographics
NPI:1396415501
Name:THECOOLLINEORG
Entity Type:Organization
Organization Name:THECOOLLINEORG
Other - Org Name:MARRIAGE & FAMILY INSTITUTE OF COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER, EXEC. DIRECTOR, THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:R CANNON
Authorized Official - Last Name:GABLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, ADDC
Authorized Official - Phone:303-357-9743
Mailing Address - Street 1:3027 KNOLLS END DR UNIT 5
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5827
Mailing Address - Country:US
Mailing Address - Phone:303-357-9743
Mailing Address - Fax:303-985-7882
Practice Address - Street 1:12157 W CEDAR DR STE 202
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2100
Practice Address - Country:US
Practice Address - Phone:303-357-9743
Practice Address - Fax:303-985-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-18
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty