Provider Demographics
NPI:1992453377
Name:KOLSUM, LAUREN (MA, LPC)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:KOLSUM
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 1:1300 RACE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2042
Mailing Address - Country:US
Mailing Address - Phone:952-454-6949
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1514
Practice Address - Country:US
Practice Address - Phone:970-281-7933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014387101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor