Provider Demographics
NPI:1891139382
Name:COSTENARO, ALLISON (LPC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:COSTENARO
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:PO BOX 563
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80402-0563
Mailing Address - Country:US
Mailing Address - Phone:303-731-9969
Mailing Address - Fax:
Practice Address - Street 1:1113 WASHINGTON AVE STE 110
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-0716
Practice Address - Country:US
Practice Address - Phone:303-731-9969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional