Provider Demographics
NPI:1689115131
Name:MECHERIKOFF, CHANDRA (LPC)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:MECHERIKOFF
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 1:3351 E 120TH AVE
Mailing Address - Street 2:UNIT 25-102
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-2357
Mailing Address - Country:US
Mailing Address - Phone:720-208-6231
Mailing Address - Fax:
Practice Address - Street 1:320 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2716
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0013160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health