Basic Information
| Provider Information | |||||||||
| NPI: | 1215032032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCQUAIN | ||||||||
| FirstName: | TREVOR | ||||||||
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| Credential: | M.A., LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 OXFORD LANE | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703472120 | ||||||||
| FaxNumber: | 9703533906 | ||||||||
| Practice Location | |||||||||
| Address1: | 4025 SAINT CLOUD DRIVE | ||||||||
| Address2: | SUITE 230 | ||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9704493559 | ||||||||
| FaxNumber: | 9703533906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 10/15/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 4602 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.