Provider Demographics
NPI:1588168736
Name:DENNARD, PATRICIA LOUISE (LPC, NCC, RPT)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LOUISE
Last Name:DENNARD
Suffix:
Gender:F
Credentials:LPC, NCC, RPT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:LOUISE
Other - Last Name:MATHEWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5855 LEHMAN DRIVE 80918
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:719-329-1900
Mailing Address - Fax:719-329-1901
Practice Address - Street 1:5855 LEHMAN DRIVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:719-329-1900
Practice Address - Fax:719-329-1901
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORPTT3325101YP2500X
COLPC0011314101YP2500X, 101YM0800X
COSSP172075101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty