Provider Demographics
NPI:1063193019
Name:WINCHELL, LOIS M
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:M
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 COCOANUT AVE UNIT 211
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5029
Mailing Address - Country:US
Mailing Address - Phone:303-868-5713
Mailing Address - Fax:
Practice Address - Street 1:2325 FOREST ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-3242
Practice Address - Country:US
Practice Address - Phone:303-830-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY0001809103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist