Provider Demographics
NPI:1316422942
Name:LAZO, CAROL M (LPCC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:LAZO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13389 FOLSOM BLVD. #200
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:424-488-6422
Mailing Address - Fax:213-652-6332
Practice Address - Street 1:13389 FOLSOM BLVD. #200
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:424-488-6422
Practice Address - Fax:213-652-6332
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 103TE1100X
CA17239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports