Provider Demographics
NPI:1154744845
Name:TCHEUNOU, TAMARA TRAGER (MA, LPC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:TRAGER
Last Name:TCHEUNOU
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:TRAGER
Other - Last Name:TCHEUNOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5347 S VALENTIA WAY
Mailing Address - Street 2:120
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3107
Mailing Address - Country:US
Mailing Address - Phone:303-641-1004
Mailing Address - Fax:
Practice Address - Street 1:5347 S VALENTIA WAY
Practice Address - Street 2:120
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3107
Practice Address - Country:US
Practice Address - Phone:303-641-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional