Provider Demographics
NPI:1265405443
Name:AYERS, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 S ELATI ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4483
Mailing Address - Country:US
Mailing Address - Phone:303-654-4355
Mailing Address - Fax:303-794-4281
Practice Address - Street 1:7800 S ELATI ST
Practice Address - Street 2:SUITE 230
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4483
Practice Address - Country:US
Practice Address - Phone:303-654-4355
Practice Address - Fax:303-794-4281
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X
CO884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional