Provider Demographics
NPI:1396417747
Name:DEARY, DEMETRIA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:DEMETRIA
Middle Name:
Last Name:DEARY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 WELTON ST STE 200-1013
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3300
Mailing Address - Country:US
Mailing Address - Phone:720-738-4333
Mailing Address - Fax:
Practice Address - Street 1:2590 WELTON ST STE 200-1013
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3300
Practice Address - Country:US
Practice Address - Phone:720-738-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional