Provider Demographics
NPI:1063936383
Name:PRESNALL, ANDREA (LPCC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:PRESNALL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8787 TURNPIKE DR STE 270
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8787 TURNPIKE PKWY,
Practice Address - Street 2:STE 270
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031
Practice Address - Country:US
Practice Address - Phone:720-609-2094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2018-04-05
Deactivation Date:2017-12-05
Deactivation Code:
Reactivation Date:2018-04-05
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0015277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional