Healthcare Provider Details

I. General information

NPI: 1265786529
Provider Name (Legal Business Name): LAWRENCE ALGIENE LPC, CAC II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 18TH AVE
LONGMONT CO
80501-9708
US

IV. Provider business mailing address

2349 LANYON DR
LONGMONT CO
80503-3658
US

V. Phone/Fax

Practice location:
  • Phone: 720-878-6444
  • Fax:
Mailing address:
  • Phone: 720-878-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-5997
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACB-7417
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: