Provider Demographics
NPI:1619212230
Name:HERNANDEZ, MARGARET ELIZABETH (MA, LAC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8199 WELBY RD APT 2104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80229-5633
Mailing Address - Country:US
Mailing Address - Phone:720-885-7497
Mailing Address - Fax:
Practice Address - Street 1:8199 WELBY RD APT 2104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80229-5633
Practice Address - Country:US
Practice Address - Phone:720-885-7497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
COACD.0002364101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty