Provider Demographics
NPI:1528273729
Name:LINDSAY, DIANE BERNICE (MA, LPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:BERNICE
Last Name:LINDSAY
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 1:2993 S PEORIA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5707
Mailing Address - Country:US
Mailing Address - Phone:720-434-1846
Mailing Address - Fax:720-408-8177
Practice Address - Street 1:2993 S PEORIA ST STE 200
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5707
Practice Address - Country:US
Practice Address - Phone:720-434-1846
Practice Address - Fax:720-408-8177
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81186703Medicaid