Provider Demographics
NPI:1457699340
Name:VAN HAECKE, EMILIE ELIZABETH (MA)
Entity Type:Individual
Prefix:
First Name:EMILIE
Middle Name:ELIZABETH
Last Name:VAN HAECKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:EMILIE
Other - Middle Name:
Other - Last Name:TRENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 INVERNESS DR W
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5095
Mailing Address - Country:US
Mailing Address - Phone:303-730-8858
Mailing Address - Fax:
Practice Address - Street 1:6509 S SANTA FE DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2910
Practice Address - Country:US
Practice Address - Phone:303-730-8858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional