Individual
ELLEN SEVIGNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
726 PEARL ST STE C, BOULDER, CO 80302-3609
(120) 766-4922
Mailing address
2201 PEARL ST APT 319, BOULDER, CO 80302-4683
(207) 664-9220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NLC.0108363
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NLC.0108363
REGISTERED PSYCHOTHERAPIST
CO
Enumeration date
05/27/2018
Last updated
05/27/2018
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