Provider Demographics
NPI:1720718455
Name:VIENNEAU, ERIK (LPC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:VIENNEAU
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6429 ELAINE RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7055
Mailing Address - Country:US
Mailing Address - Phone:970-390-4318
Mailing Address - Fax:
Practice Address - Street 1:2942 EVERGREEN PKWY STE 200
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-2223
Practice Address - Country:US
Practice Address - Phone:970-390-4318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health