Provider Demographics
NPI:1558827659
Name:PRINTZ, PRISCILLA (LPC0016571)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:PRINTZ
Suffix:
Gender:F
Credentials:LPC0016571
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 COTTONWOOD LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3739
Mailing Address - Country:US
Mailing Address - Phone:815-641-4854
Mailing Address - Fax:
Practice Address - Street 1:4540 COTTONWOOD LAKES BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3739
Practice Address - Country:US
Practice Address - Phone:815-641-4854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional