Individual
TREVOR JEROME LENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S., C.A.S., R.C.
Contact information
Practice address
3400 W 16TH ST STE P, GREELEY, CO 80634-6871
(970) 978-4386
Mailing address
2924 ROSS DR APT J26, FORT COLLINS, CO 80526-1178
(720) 240-1564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0998578
CO
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15152227
CAQH
CO
Enumeration date
04/08/2021
Last updated
03/02/2022
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