Provider Demographics
NPI:1740429570
Name:SCHWABE, ALYSON (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:SCHWABE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 IDYLWILD TRL
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3571
Mailing Address - Country:US
Mailing Address - Phone:303-960-7917
Mailing Address - Fax:303-530-1517
Practice Address - Street 1:5412 IDYLWILD TRL
Practice Address - Street 2:SUITE 112
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3571
Practice Address - Country:US
Practice Address - Phone:303-960-7917
Practice Address - Fax:303-530-1517
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional