1215032032 NPI number — TREVOR MCQUAIN M.A., LPC

Table of content: TREVOR MCQUAIN M.A., LPC (NPI 1215032032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215032032 NPI number — TREVOR MCQUAIN M.A., LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCQUAIN
Provider First Name:
TREVOR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., LPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215032032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 OXFORD LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-347-2120
Provider Business Mailing Address Fax Number:
970-353-3906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4025 SAINT CLOUD DRIVE
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
LOVELAND
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-449-3559
Provider Business Practice Location Address Fax Number:
970-353-3906
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 4602 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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