MEDICARE: FRANCES LACSON MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	NLC.0108728	CO
2	101YM0800X	Mental Health Counselor	LPCC.0017974	CO

General Provider Information

NPI Number	:	1780286104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES LACSON MA

Provider Business Mailing Address
First Line	:	3333 IRIS AVE STE 209
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-1998
Country	:	US
Telephone Number	:	720-336-8783
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 IRIS AVE STE 209
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-1998
Country	:	US
Telephone Number	:	720-336-8783
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	01/22/2021

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Directions to “ FRANCES LACSON MA” Practice Location

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