Provider Demographics
NPI:1548755101
Name:FERACHI, MARY CLAIRE (MA, LPC, LAC)
Entity Type:Individual
Prefix:
First Name:MARY CLAIRE
Middle Name:
Last Name:FERACHI
Suffix:
Gender:F
Credentials:MA, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 E CRESTLINE CIR STE 118
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3652
Mailing Address - Country:US
Mailing Address - Phone:720-740-5952
Mailing Address - Fax:
Practice Address - Street 1:7400 E CRESTLINE CIR STE 118
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3652
Practice Address - Country:US
Practice Address - Phone:720-740-5952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001783101YA0400X
COLPC.0016205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)