Provider Demographics
NPI:1386937886
Name:ACKLER, GINA CRAGO (LPC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:CRAGO
Last Name:ACKLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 SHERIDAN BLVD STE 223B
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-6142
Mailing Address - Country:US
Mailing Address - Phone:303-426-5066
Mailing Address - Fax:
Practice Address - Street 1:8120 SHERIDAN BLVD STE 223B
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-6142
Practice Address - Country:US
Practice Address - Phone:303-426-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2570101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health