Provider Demographics
NPI:1629249503
Name:CORDOVA, ANGELINA R (MA, CACIII, LMFT)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:R
Last Name:CORDOVA
Suffix:
Gender:F
Credentials:MA, CACIII, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6595 S DAYTON ST
Mailing Address - Street 2:STE 1200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6143
Mailing Address - Country:US
Mailing Address - Phone:303-549-3891
Mailing Address - Fax:844-272-6033
Practice Address - Street 1:6595 S DAYTON ST
Practice Address - Street 2:STE 1200
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-6143
Practice Address - Country:US
Practice Address - Phone:720-488-0878
Practice Address - Fax:844-272-6033
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6435101YA0400X
CO880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist