Provider Demographics
NPI:1588772909
Name:LATIMORE, CAROL DICICCO (LPC)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:DICICCO
Last Name:LATIMORE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:DICICCO
Other - Last Name:GANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8778 WOLFF CT
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6901
Mailing Address - Country:US
Mailing Address - Phone:203-940-1477
Mailing Address - Fax:303-940-9220
Practice Address - Street 1:8778 WOLFF CT
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6901
Practice Address - Country:US
Practice Address - Phone:203-940-1477
Practice Address - Fax:303-940-9220
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 1052101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor