1417159302 NPI number — MRS. MELANNE LOUISE BATTENHOUSE LPC

Table of content: MRS. MELANNE LOUISE BATTENHOUSE LPC (NPI 1417159302)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417159302 NPI number — MRS. MELANNE LOUISE BATTENHOUSE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATTENHOUSE
Provider First Name:
MELANNE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

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:
1417159302
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1034 S JACKSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80209-5016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-918-6220
Provider Business Mailing Address Fax Number:
303-757-2795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
494 SHERIDAN BLVD
Provider Second Line Business Practice Location Address:
SUITE #A201
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80226-8106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-756-9746
Provider Business Practice Location Address Fax Number:
303-757-2795
Provider Enumeration Date:
06/03/2007

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: 101YP2500X , with the licence number:  3500 , 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)

  • Identifier: 7699753 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11556953 . This is a "COUNCIL FOR AFFORDABLE QU" identifier . This identifiers is of the category "OTHER".




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