Provider Demographics
NPI:1932880929
Name:ACOSTA LOZANO, THALIA NOHEMI
Entity type:Individual
Prefix:
First Name:THALIA
Middle Name:NOHEMI
Last Name:ACOSTA LOZANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7596 W JEWELL AVE # 1-202
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6889
Mailing Address - Country:US
Mailing Address - Phone:720-739-0676
Mailing Address - Fax:
Practice Address - Street 1:7596 W JEWELL AVE # 1-202
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6889
Practice Address - Country:US
Practice Address - Phone:720-739-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0023073101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health