Provider Demographics
NPI:1154517076
Name:LACZYNSKI, MELINDA (LPC)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:LACZYNSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 E. EXPOSITION AVE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:720-280-9170
Mailing Address - Fax:
Practice Address - Street 1:3955 E EXPOSITION AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5000
Practice Address - Country:US
Practice Address - Phone:720-280-9170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional