Provider Demographics
NPI:1508550740
Name:RAIMER, CHANTEL (LPCC)
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:
Last Name:RAIMER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 W 29TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2459
Mailing Address - Country:US
Mailing Address - Phone:970-430-6508
Mailing Address - Fax:
Practice Address - Street 1:1006 ROBERTSON ST STE 220
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3920
Practice Address - Country:US
Practice Address - Phone:970-775-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional