Provider Demographics
NPI:1730467218
Name:VESPA, AMY MARIE (LPC, MAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:VESPA
Suffix:
Gender:F
Credentials:LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 GRAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-3478
Mailing Address - Country:US
Mailing Address - Phone:970-618-6542
Mailing Address - Fax:970-947-0055
Practice Address - Street 1:620 BRIDGEWATER PL
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2185
Practice Address - Country:US
Practice Address - Phone:970-618-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6152101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health