Provider Demographics
NPI:1952801854
Name:COUNTS, CAROL JEANETTE
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEANETTE
Last Name:COUNTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 WADSWORTH BLVD STE P
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5733
Mailing Address - Country:US
Mailing Address - Phone:303-238-5755
Mailing Address - Fax:303-231-9035
Practice Address - Street 1:2099 WADSWORTH BLVD STE P
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5733
Practice Address - Country:US
Practice Address - Phone:303-238-5755
Practice Address - Fax:303-231-9035
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1624661163WM0705X
LPC.0013370101YP2500X
ACB.0008180101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional