Provider Demographics
NPI:1194262329
Name:POWERS, TERESA (LPC, MS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-5521
Mailing Address - Country:US
Mailing Address - Phone:541-373-7863
Mailing Address - Fax:
Practice Address - Street 1:1201 W STANFORD AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-5521
Practice Address - Country:US
Practice Address - Phone:541-373-7863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
CO0015000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175F00000XOther Service ProvidersNaturopath