Provider Demographics
NPI:1093192460
Name:LAWRENCE, LENDOL W (LPC)
Entity type:Individual
Prefix:
First Name:LENDOL
Middle Name:W
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10100
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-0008
Mailing Address - Country:US
Mailing Address - Phone:970-874-5777
Mailing Address - Fax:970-546-4030
Practice Address - Street 1:296 STAFFORD LANE, SUITE A
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2282
Practice Address - Country:US
Practice Address - Phone:970-874-5777
Practice Address - Fax:970-546-4030
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC0012427101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional