Provider Demographics
NPI:1467533984
Name:MCINTYRE, JOHN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 COFFMAN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5451
Mailing Address - Country:US
Mailing Address - Phone:720-494-2541
Mailing Address - Fax:720-494-7713
Practice Address - Street 1:500 COFFMAN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5451
Practice Address - Country:US
Practice Address - Phone:720-494-2541
Practice Address - Fax:720-494-7713
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO538106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist