Provider Demographics
NPI:1790305712
Name:DYE, CAMILLA F (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLA
Middle Name:F
Last Name:DYE
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 1:350 EAST STREET #56
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-0056
Mailing Address - Country:US
Mailing Address - Phone:720-282-1727
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:491 W SPRING STREET
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466
Practice Address - Country:US
Practice Address - Phone:720-282-1727
Practice Address - Fax:866-757-5778
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-20
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000183797Medicaid