Provider Demographics
NPI:1730930678
Name:MASOTTI, TERRYANN STILWELL (RN, MA, LPCC)
Entity type:Individual
Prefix:
First Name:TERRYANN
Middle Name:STILWELL
Last Name:MASOTTI
Suffix:
Gender:F
Credentials:RN, MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8045 JAMES CT
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7610
Mailing Address - Country:US
Mailing Address - Phone:505-699-9662
Mailing Address - Fax:
Practice Address - Street 1:8045 JAMES CT
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-7610
Practice Address - Country:US
Practice Address - Phone:505-699-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC-0020165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health