Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 3980LPC | CO |
Y | 101Y00000X | Counselor | LPC | CO |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 232LAC | CO |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 6360 | CO |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LAC | CO |
N | 101YM0800X | Mental Health Counselor | LAC232 | CO |
N | 101YP1600X | Pastoral Counselor | 3980 | CO |
N | 101YP2500X | Professional Counselor | 3980 | CO |
N | 101YP2500X | Professional Counselor | 3980-LPC | CO |
NPI | 1063425122 |
---|---|
Provider Name | Abigail W Lavoo |
First Address | Colo Springs, CO 80919 |
Second Address | Colorado Springs, CO 80920-8231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 15/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28632508 | (05) | CO |