Provider Demographics
NPI:1255872149
Name:TEN EYCK, COLLEEN JANE (LAC, LCSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:JANE
Last Name:TEN EYCK
Suffix:
Gender:F
Credentials:LAC, LCSW
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:JANE
Other - Last Name:RIORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC, LCSW
Mailing Address - Street 1:3092 S IVAN WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3838
Mailing Address - Country:US
Mailing Address - Phone:815-575-1899
Mailing Address - Fax:
Practice Address - Street 1:1075 S YUKON ST STE 220
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4346
Practice Address - Country:US
Practice Address - Phone:303-351-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000818101YA0400X
COCSW.099257841041C0700X
CO0009921325104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker