Provider Demographics
NPI:1982328290
Name:GAROFALINI, DANA M
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:GAROFALINI
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 1:77 3RD ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8179
Mailing Address - Country:US
Mailing Address - Phone:719-259-4951
Mailing Address - Fax:
Practice Address - Street 1:77 3RD ST STE 400
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8179
Practice Address - Country:US
Practice Address - Phone:719-259-4951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002302-01101YM0800X
CO0017911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0017911OtherDORA
NY002302-01OtherOFFICE OF PROFESSIONALS