Provider Demographics
NPI:1558898965
Name:MOONFIELD, NICOLE MUNOZ (LPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MUNOZ
Last Name:MOONFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:612 N WASHINGTON ST STE 112
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3800
Mailing Address - Country:US
Mailing Address - Phone:720-515-1332
Mailing Address - Fax:
Practice Address - Street 1:612 N WASHINGTON ST STE 112
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3800
Practice Address - Country:US
Practice Address - Phone:720-515-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016179101YP2500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program