Provider Demographics
NPI:1194971762
Name:HAVICE, PAULA J (LPC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:HAVICE
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 1:1007 OLD DUTCH MILL RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3661
Mailing Address - Country:US
Mailing Address - Phone:719-310-3860
Mailing Address - Fax:
Practice Address - Street 1:1007 OLD DUTCH MILL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3661
Practice Address - Country:US
Practice Address - Phone:719-310-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2023-11-15
Deactivation Date:2021-02-11
Deactivation Code:
Reactivation Date:2021-09-02
Provider Licenses
StateLicense IDTaxonomies
CO3677101YA0400X
CO2009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)