Healthcare Provider Details

I. General information

NPI: 1841544111
Provider Name (Legal Business Name): DEBORAH S EDSALL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 W 10TH ST STE 200
GREELEY CO
80634-4468
US

IV. Provider business mailing address

5401 W 10TH ST STE 200
GREELEY CO
80634-4468
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax:
Mailing address:
  • Phone: 970-310-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0003229
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0003229
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: