Basic Information
| Provider Information | |||||||||
| NPI: | 1164914842 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SICKING | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | JOSETTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 28 3/4 RD | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815015016 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 137 HOWARD ST. | ||||||||
| Address2: | |||||||||
| City: | EAGLE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816310000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703286969 | ||||||||
| FaxNumber: | 9703286329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2018 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LPC.0017146 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.