Provider Demographics
NPI:1275375362
Name:MCLAUGHLIN, GENA ANDREA
Entity type:Individual
Prefix:
First Name:GENA
Middle Name:ANDREA
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 SAINT PAUL ST UNIT 311
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1669
Mailing Address - Country:US
Mailing Address - Phone:303-552-8509
Mailing Address - Fax:
Practice Address - Street 1:8490 E CRESCENT PKWY
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2843
Practice Address - Country:US
Practice Address - Phone:303-552-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022035101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health