Provider Demographics
NPI:1215827340
Name:THE CHANGE LAB COUNSELING AND CONSULTING PLLC
Entity type:Organization
Organization Name:THE CHANGE LAB COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-829-5853
Mailing Address - Street 1:3030 S COLLEGE AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 S COLLEGE AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2557
Practice Address - Country:US
Practice Address - Phone:970-297-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health