Healthcare Provider Details

I. General information

NPI: 1215827340
Provider Name (Legal Business Name): THE CHANGE LAB COUNSELING AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 S COLLEGE AVE UNIT 207
FORT COLLINS CO
80525-2557
US

IV. Provider business mailing address

3030 S COLLEGE AVE UNIT 207
FORT COLLINS CO
80525-2557
US

V. Phone/Fax

Practice location:
  • Phone: 970-297-0020
  • 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: LARISSA CAMBEL
Title or Position: PRACTICE OWNER/COUNSELOR
Credential:
Phone: 970-829-5853