Provider Demographics
NPI:1255926218
Name:FERREN, LENNI ROBIN (NLC)
Entity type:Individual
Prefix:
First Name:LENNI
Middle Name:ROBIN
Last Name:FERREN
Suffix:
Gender:F
Credentials:NLC
Other - Prefix:
Other - First Name:LENNI
Other - Middle Name:ROBIN
Other - Last Name:DUNCANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NLC
Mailing Address - Street 1:4945 TWIN LAKES RD APT 45
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3889
Mailing Address - Country:US
Mailing Address - Phone:303-818-6803
Mailing Address - Fax:
Practice Address - Street 1:1200 28TH ST STE 205
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1756
Practice Address - Country:US
Practice Address - Phone:303-993-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO031679Medicaid