Provider Demographics
NPI:1477832749
Name:HIDALGO, JAMIE QUINN (MA, LPC, ADDC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:QUINN
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:MA, LPC, ADDC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:QUINN
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:420 E 58TH AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-1400
Mailing Address - Country:US
Mailing Address - Phone:720-937-9758
Mailing Address - Fax:
Practice Address - Street 1:420 E 58TH AVE STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-1400
Practice Address - Country:US
Practice Address - Phone:720-937-9758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COADDC.0000312101YA0400X
COLPC.0012465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)