Provider Demographics
NPI:1720310865
Name:EELLS, STEPHANIE JENNIFER (LPC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:JENNIFER
Last Name:EELLS
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 1:8015 W ALAMEDA AVE # G-50
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3041
Mailing Address - Country:US
Mailing Address - Phone:720-254-0494
Mailing Address - Fax:
Practice Address - Street 1:8015 W ALAMEDA AVE # G-50
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3041
Practice Address - Country:US
Practice Address - Phone:720-254-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-30
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO24326569Medicaid