Provider Demographics
NPI:1922875731
Name:LANDRY, ALYSSA (MA, LPCC, NCC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:LANDRY
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 E 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8157
Mailing Address - Country:US
Mailing Address - Phone:512-818-6958
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST STE 377
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2808
Practice Address - Country:US
Practice Address - Phone:720-318-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health