Provider Demographics
NPI:1881359958
Name:GILLESPIE, AFTIN MARIE (LPC)
Entity type:Individual
Prefix:
First Name:AFTIN
Middle Name:MARIE
Last Name:GILLESPIE
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 1:812 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2515
Mailing Address - Country:US
Mailing Address - Phone:719-480-3829
Mailing Address - Fax:
Practice Address - Street 1:1738 WYNKOOP ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-5925
Practice Address - Country:US
Practice Address - Phone:844-843-7279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0015626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health