Provider Demographics
NPI:1508163551
Name:ZACKROFF, LYNNELLE MARIE (MASTERS, LPC)
Entity Type:Individual
Prefix:
First Name:LYNNELLE
Middle Name:MARIE
Last Name:ZACKROFF
Suffix:
Gender:F
Credentials:MASTERS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 E 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1636
Mailing Address - Country:US
Mailing Address - Phone:303-388-1303
Mailing Address - Fax:
Practice Address - Street 1:2940 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1636
Practice Address - Country:US
Practice Address - Phone:303-388-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-26
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2652101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor