Provider Demographics
NPI:1861906273
Name:NADEAU, LEE DOUGLAS (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:LEE
Middle Name:DOUGLAS
Last Name:NADEAU
Suffix:
Gender:M
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 1:1028 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3148
Mailing Address - Country:US
Mailing Address - Phone:970-227-3450
Mailing Address - Fax:
Practice Address - Street 1:1028 DRIFTWOOD DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3148
Practice Address - Country:US
Practice Address - Phone:970-227-3450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013953101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor