Healthcare Provider Details

I. General information

NPI: 1215807623
Provider Name (Legal Business Name): LAUREN BETIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 TAHOSA PARK NORTH RD
ALLENSPARK CO
80510
US

IV. Provider business mailing address

435 TAHOSA PARK NORTH RD
ALLENSPARK CO
80510
US

V. Phone/Fax

Practice location:
  • Phone: 254-314-8937
  • Fax:
Mailing address:
  • Phone: 254-314-8937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100382
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0024211
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: