Basic Information
| Provider Information | |||||||||
| NPI: | 1508057928 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDONNELL | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PATRICK | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 INVERNESS DR W | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801125095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037939634 | ||||||||
| FaxNumber: | 3038890838 | ||||||||
| Practice Location | |||||||||
| Address1: | 5500 S SYCAMORE ST | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801208201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037979440 | ||||||||
| FaxNumber: | 3038890838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2007 | ||||||||
| LastUpdateDate: | 06/12/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 0096661 | NM | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | LPC-12464 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.