Provider Demographics
NPI:1558694513
Name:MCQUARRIE, JAMIE LAUCHLIN (MSW, CAC III)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LAUCHLIN
Last Name:MCQUARRIE
Suffix:
Gender:M
Credentials:MSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1644 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1007
Mailing Address - Country:US
Mailing Address - Phone:970-567-0961
Mailing Address - Fax:970-221-2727
Practice Address - Street 1:1644 S. COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526
Practice Address - Country:US
Practice Address - Phone:970-567-0961
Practice Address - Fax:970-221-2727
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0006850101YA0400X
CO101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACC.0006850Medicaid