Provider Demographics
NPI:1215090014
Name:QUADREL, PATRICE A (LMFT, CACIII)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:A
Last Name:QUADREL
Suffix:
Gender:F
Credentials:LMFT, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 DIXON CREEK LN
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6271
Mailing Address - Country:US
Mailing Address - Phone:970-215-9935
Mailing Address - Fax:
Practice Address - Street 1:503 REMINGTON ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3074
Practice Address - Country:US
Practice Address - Phone:970-215-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4418101YA0400X
CO432106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist