Provider Demographics
NPI:1235694423
Name:CORDOVA-BARNES, ANNABELLA R (LPCC)
Entity type:Individual
Prefix:
First Name:ANNABELLA
Middle Name:R
Last Name:CORDOVA-BARNES
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 1:350 INTERLOCKEN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3478
Mailing Address - Country:US
Mailing Address - Phone:720-523-1137
Mailing Address - Fax:
Practice Address - Street 1:350 INTERLOCKEN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3478
Practice Address - Country:US
Practice Address - Phone:720-523-1137
Practice Address - Fax:720-523-1137
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0015800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional