Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | LPC.0011891 | CO |
NPI | 1003129370 |
---|---|
Provider Name | Lori Ellen Stalcar |
First Address | Colorado Springs, CO 80916-2332 |
Second Address | Colorado Springs, CO 80910-3130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2010 |
Last Update Date | 27/10/2021 |