Provider Demographics
NPI:1538578398
Name:DAVIS-TIMMS, COLLEEN (LPC, CACII)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:DAVIS-TIMMS
Suffix:
Gender:F
Credentials:LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:TABERNASH
Mailing Address - State:CO
Mailing Address - Zip Code:80478-0415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79050 US HWY 40
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:CO
Practice Address - Zip Code:80482
Practice Address - Country:US
Practice Address - Phone:970-531-7537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB7798101YA0400X
COLPC.0013935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)