Provider Demographics
NPI:1952335044
Name:BOON, COSETTE LYNN (MA; LPC)
Entity Type:Individual
Prefix:MS
First Name:COSETTE
Middle Name:LYNN
Last Name:BOON
Suffix:
Gender:F
Credentials:MA; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 FRONT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1870
Mailing Address - Country:US
Mailing Address - Phone:303-665-2300
Mailing Address - Fax:
Practice Address - Street 1:726 FRONT ST
Practice Address - Street 2:SUITE D
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1870
Practice Address - Country:US
Practice Address - Phone:303-665-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1041OtherLPC
CO673663OtherANTEM ID