Provider Demographics
NPI:1851501779
Name:HENNE, STEVEN RONALD (MA, LPC, LAC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RONALD
Last Name:HENNE
Suffix:
Gender:M
Credentials:MA, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-0335
Mailing Address - Country:US
Mailing Address - Phone:303-818-1366
Mailing Address - Fax:303-258-0698
Practice Address - Street 1:613 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5031
Practice Address - Country:US
Practice Address - Phone:303-818-1366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104101YA0400X
CO1589101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional