Provider Demographics
NPI:1659135283
Name:APODACA, RENEE V (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:V
Last Name:APODACA
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 1:1607 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY FORD
Mailing Address - State:CO
Mailing Address - Zip Code:81067-2235
Mailing Address - Country:US
Mailing Address - Phone:719-469-9084
Mailing Address - Fax:
Practice Address - Street 1:1607 PINE AVE
Practice Address - Street 2:
Practice Address - City:ROCKY FORD
Practice Address - State:CO
Practice Address - Zip Code:81067-2235
Practice Address - Country:US
Practice Address - Phone:719-469-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005593101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health