Provider Demographics
NPI:1922340959
Name:SEVERINE, BRIANA L (MS, LPCC, CACII,CPRP)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:L
Last Name:SEVERINE
Suffix:
Gender:F
Credentials:MS, LPCC, CACII,CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 S RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5144
Mailing Address - Country:US
Mailing Address - Phone:562-618-2319
Mailing Address - Fax:
Practice Address - Street 1:3867 TENNYSON STREET #D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2664
Practice Address - Country:US
Practice Address - Phone:562-618-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor