Provider Demographics
NPI:1942683974
Name:SUMMERS, DAVID (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3555
Mailing Address - Country:US
Mailing Address - Phone:720-295-0089
Mailing Address - Fax:
Practice Address - Street 1:1777 S HARRISON ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3925
Practice Address - Country:US
Practice Address - Phone:720-295-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.00112286101Y00000X
COACD.00005111101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)