Provider Demographics
NPI:1437373743
Name:CHENIS, PATTI LEE (LPC)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:LEE
Last Name:CHENIS
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 1:955 LARAMIE BLVD
Mailing Address - Street 2:UNIT G
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4729
Mailing Address - Country:US
Mailing Address - Phone:720-562-0538
Mailing Address - Fax:303-661-0818
Practice Address - Street 1:400 E SIMPSON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2394
Practice Address - Country:US
Practice Address - Phone:720-562-0538
Practice Address - Fax:303-661-0818
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2350101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health