Healthcare Provider Details

I. General information

NPI: 1992614770
Provider Name (Legal Business Name): LAUREN EISELE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARAPAHOE AVE
BOULDER CO
80302-5854
US

IV. Provider business mailing address

5438 PARADISE LN
FORT COLLINS CO
80526-4325
US

V. Phone/Fax

Practice location:
  • Phone: 970-219-8717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAUREN J EISELE
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 720-466-3193