Healthcare Provider Details

I. General information

NPI: 1336822931
Provider Name (Legal Business Name): LAUREN PUCCI LPC.0022596
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 BRODIE AVE
ESTES PARK CO
80517-5428
US

IV. Provider business mailing address

3315 GLADE RD
LOVELAND CO
80538-9432
US

V. Phone/Fax

Practice location:
  • Phone: 720-384-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0022596
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: