Provider Demographics
NPI:1114811197
Name:ZENTENO-SPENCER, MIRIAM ANGELICA (LPCC)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:ANGELICA
Last Name:ZENTENO-SPENCER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-3110
Mailing Address - Country:US
Mailing Address - Phone:719-680-5658
Mailing Address - Fax:
Practice Address - Street 1:707 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-3110
Practice Address - Country:US
Practice Address - Phone:719-680-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0023454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional