Provider Demographics
NPI:1124433941
Name:WILLIAMS, LORRINE (SWC, LAC, E-RYT)
Entity type:Individual
Prefix:
First Name:LORRINE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SWC, LAC, E-RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E MONUMENT ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1004
Mailing Address - Country:US
Mailing Address - Phone:719-447-0370
Mailing Address - Fax:
Practice Address - Street 1:212 E MONUMENT ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1004
Practice Address - Country:US
Practice Address - Phone:719-447-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB 0007561101YA0400X
COACD.0001897101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)