Provider Demographics
NPI:1871173773
Name:SPINLER, DWAYNE GERALD (MS, LPC, LAC)
Entity type:Individual
Prefix:
First Name:DWAYNE
Middle Name:GERALD
Last Name:SPINLER
Suffix:
Gender:M
Credentials:MS, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13417 UINTA ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8493
Mailing Address - Country:US
Mailing Address - Phone:970-481-4480
Mailing Address - Fax:
Practice Address - Street 1:13417 UINTA ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-8493
Practice Address - Country:US
Practice Address - Phone:970-481-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9704814480OtherN/A