Provider Demographics
NPI:1497476261
Name:STOBIE, ANTHEA GRACE (MA, LPCC, R-DMT)
Entity Type:Individual
Prefix:
First Name:ANTHEA
Middle Name:GRACE
Last Name:STOBIE
Suffix:
Gender:F
Credentials:MA, LPCC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13731 E RICE PL STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1077
Mailing Address - Country:US
Mailing Address - Phone:720-949-1707
Mailing Address - Fax:
Practice Address - Street 1:13731 E RICE PL STE 200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1077
Practice Address - Country:US
Practice Address - Phone:720-949-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019709101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84-379-3311Medicaid