Provider Demographics
NPI:1790021335
Name:FESTA, NICOLE DION (MA, LAC, NCAC I, NCC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:DION
Last Name:FESTA
Suffix:
Gender:F
Credentials:MA, LAC, NCAC I, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10327 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-2003
Mailing Address - Country:US
Mailing Address - Phone:207-379-6995
Mailing Address - Fax:
Practice Address - Street 1:10327 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2003
Practice Address - Country:US
Practice Address - Phone:720-379-6995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-01
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0015213101YM0800X
COACD.0000813101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health