Provider Demographics
NPI:1255463006
Name:QUINTANA-PRICE, TANA VICTORIA (LPC)
Entity type:Individual
Prefix:MRS
First Name:TANA
Middle Name:VICTORIA
Last Name:QUINTANA-PRICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28179 ALABRASKA LN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-6560
Mailing Address - Country:US
Mailing Address - Phone:303-477-3522
Mailing Address - Fax:
Practice Address - Street 1:6949 HIGHWAY 73 COUNTY RD STE 5
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-8043
Practice Address - Country:US
Practice Address - Phone:303-477-3522
Practice Address - Fax:303-456-0607
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12755697OtherCAQH
CO77061OtherHEALTH FRIST
CO19072848Medicaid