Provider Demographics
NPI:1053372409
Name:MANN, LINDA LEE (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:MANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:PANNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 221503
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-1014
Mailing Address - Country:US
Mailing Address - Phone:720-233-9186
Mailing Address - Fax:
Practice Address - Street 1:303 W COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2621
Practice Address - Country:US
Practice Address - Phone:720-233-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1887101YP2500X
CO5495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
2136753OtherCIGNA BEHAVIORAL HEALTH