Provider Demographics
NPI:1366534927
Name:PEARSON, VAUNDA (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:VAUNDA
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:MS
Other - First Name:VAUNDA
Other - Middle Name:PEARSON
Other - Last Name:YENZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 E HORSETOOTH RD BLDG 3101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3197
Mailing Address - Country:US
Mailing Address - Phone:970-310-3406
Mailing Address - Fax:
Practice Address - Street 1:375 E HORSETOOTH RD BLDG 3101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3197
Practice Address - Country:US
Practice Address - Phone:970-578-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019785101YM0800X
FLMH 9416101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766937200Medicaid