Provider Demographics
NPI:1467995258
Name:ERMAKOV, INNA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:INNA
Middle Name:
Last Name:ERMAKOV
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 1:6746 S REVERE PKWY STE 135
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6708
Mailing Address - Country:US
Mailing Address - Phone:720-261-8818
Mailing Address - Fax:
Practice Address - Street 1:8979 MINERS PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5057
Practice Address - Country:US
Practice Address - Phone:720-261-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0013706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC0013706OtherDORA