Provider Demographics
NPI:1619625761
Name:TRIBBLE-BENTLEY, SONDRA E (MS, LPCC, LACC,)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:E
Last Name:TRIBBLE-BENTLEY
Suffix:
Gender:F
Credentials:MS, LPCC, LACC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7561
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-0561
Mailing Address - Country:US
Mailing Address - Phone:720-243-3408
Mailing Address - Fax:
Practice Address - Street 1:1210 S PARKER RD STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2163
Practice Address - Country:US
Practice Address - Phone:720-334-8189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty