Provider Demographics
NPI:1578740239
Name:BROSSARD, LUCIE W (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LUCIE
Middle Name:W
Last Name:BROSSARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:LUCIE
Other - Middle Name:BROSSARD
Other - Last Name:KIWIMAGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1870 W 122ND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2075
Mailing Address - Country:US
Mailing Address - Phone:303-853-3500
Mailing Address - Fax:303-853-3702
Practice Address - Street 1:8989 HURON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6858
Practice Address - Country:US
Practice Address - Phone:303-853-3500
Practice Address - Fax:303-853-3702
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3265101YP2500X
COLPC.0003265101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional