Provider Demographics
NPI:1386257699
Name:PASS ERICKSON, LAUREN (MA, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PASS ERICKSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 VALMONT RD. #130
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:401-307-3449
Mailing Address - Fax:
Practice Address - Street 1:2955 VALMONT RD. #130
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:401-307-3449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2024-07-16
Deactivation Date:2020-08-26
Deactivation Code:
Reactivation Date:2024-07-15
Provider Licenses
StateLicense IDTaxonomies
COLPC0019080101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor