Provider Demographics
NPI:1992393227
Name:GEORGE, TAWNY (MA, LPCC)
Entity type:Individual
Prefix:
First Name:TAWNY
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 MIRCOS ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-5409
Mailing Address - Country:US
Mailing Address - Phone:720-277-5025
Mailing Address - Fax:
Practice Address - Street 1:1035 MIRCOS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-5409
Practice Address - Country:US
Practice Address - Phone:720-277-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-03
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0020279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty