Provider Demographics
NPI:1417775065
Name:THIELENS, JAMES III (LAC, LPCC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:THIELENS
Suffix:III
Gender:M
Credentials:LAC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 W 38TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1978
Mailing Address - Country:US
Mailing Address - Phone:970-232-8909
Mailing Address - Fax:
Practice Address - Street 1:4100 W 38TH AVE STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-1978
Practice Address - Country:US
Practice Address - Phone:970-232-8909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021797101Y00000X
COACD.0002414101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor