Provider Demographics
NPI:1194247924
Name:DILLABAUGH, LAURA (LPC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DILLABAUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:SIGRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, BCC
Mailing Address - Street 1:7085 NATIVE CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5004
Mailing Address - Country:US
Mailing Address - Phone:716-903-3828
Mailing Address - Fax:
Practice Address - Street 1:5390 N ACADEMY BLVD STE 330
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4176
Practice Address - Country:US
Practice Address - Phone:716-903-3828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60474608101YM0800X
CO5550101YP2500X
CO0005550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health