Provider Demographics
NPI:1336963545
Name:WELKE, MISAYO (LPCC)
Entity type:Individual
Prefix:
First Name:MISAYO
Middle Name:
Last Name:WELKE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:MISAYO
Other - Middle Name:
Other - Last Name:CROCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3077 WOLFENSBERGER RD
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:CO
Mailing Address - Zip Code:80135-8530
Mailing Address - Country:US
Mailing Address - Phone:408-828-2621
Mailing Address - Fax:
Practice Address - Street 1:1100 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2611
Practice Address - Country:US
Practice Address - Phone:720-779-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health