Provider Demographics
NPI:1861450819
Name:GARTNER, NICOLE LEVERO (LPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LEVERO
Last Name:GARTNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:LEVERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14552 STARGAZER DR
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8773
Mailing Address - Country:US
Mailing Address - Phone:303-385-3669
Mailing Address - Fax:
Practice Address - Street 1:2900 E 136TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3542
Practice Address - Country:US
Practice Address - Phone:303-385-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional