Provider Demographics
NPI:1679979801
Name:METOYER, TONY (MA, CAC II)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:METOYER
Suffix:
Gender:M
Credentials:MA, CAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 E 2ND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8327
Mailing Address - Country:US
Mailing Address - Phone:720-447-1557
Mailing Address - Fax:
Practice Address - Street 1:2502 S OURAY WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-1534
Practice Address - Country:US
Practice Address - Phone:720-447-1557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB0007498101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)