Gwendaline Danielle Thoreaux, MA, LPC, CAC | |
1333 Iris Ave, Boulder, CO 80304-2226 | |
(303) 443-0850 | |
Not Available |
Full Name | Gwendaline Danielle Thoreaux |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 1333 Iris Ave, Boulder, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912279233 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 5880 (Colorado) | Secondary |
101YP2500X | Counselor - Professional | 3210 (Colorado) | Primary |
Entity Name | Mental Health Center Of Boulder County, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093767543 PECOS PAC ID: 2163314857 Enrollment ID: O20040326001284 |
Mailing Address | Practice Location Address |
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Gwendaline Danielle Thoreaux, MA, LPC, CAC 1333 Iris Ave, Boulder, CO 80304-2226 Ph: (303) 443-8500 | Gwendaline Danielle Thoreaux, MA, LPC, CAC 1333 Iris Ave, Boulder, CO 80304-2226 Ph: (303) 443-0850 |
Ms. Glenda Russell O'rourke, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4716 Ashfield Ct, Boulder, CO 80301 Phone: 303-443-9446 Fax: 303-447-2173 | |
Veronique P Mead, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 4439 Driftwood Pl, Boulder, CO 80301 Phone: 303-581-0411 | |
Carlos Trujillo, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1333 Iris Ave, Boulder, CO 80304 Phone: 303-413-6212 | |
Guilherme Zavaschi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1333 Iris Ave, Boulder, CO 80304 Phone: 303-443-8500 | |
Ms. Regina Cannon, REGISTERED PSYCHOTHE Counselor Medicare: Not Enrolled in Medicare Practice Location: 1333 Iris Ave, Boulder, CO 80304 Phone: 303-443-8500 | |
Amanda Fielder, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1333 Iris Ave, Boulder, CO 80304 Phone: 303-443-8500 Fax: 303-449-6029 | |
Lynne Marie Andrade, MA, LPCC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3360 Everett Dr, Boulder, CO 80305 Phone: 970-532-9999 |