Provider Demographics
NPI:1427603893
Name:GIACINTO, SELINA ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:SELINA
Middle Name:ROSE
Last Name:GIACINTO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COUNTY ROAD 83
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-9720
Mailing Address - Country:US
Mailing Address - Phone:720-585-8766
Mailing Address - Fax:
Practice Address - Street 1:3080 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2152
Practice Address - Country:US
Practice Address - Phone:720-585-8766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health