Provider Demographics
NPI:1639852254
Name:NYE, CHANEL (LPC)
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:
Last Name:NYE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 W 44TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2838
Mailing Address - Country:US
Mailing Address - Phone:720-300-2162
Mailing Address - Fax:
Practice Address - Street 1:7500 W MISSISSIPPI AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4550
Practice Address - Country:US
Practice Address - Phone:720-330-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019353101YP2500X
COLPC.0020527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional