Healthcare Provider Details

I. General information

NPI: 1689596603
Provider Name (Legal Business Name): JULIAN STAIANO LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 COUNTY LINE ROAD APT C205
LONGMONT CO
80504
US

IV. Provider business mailing address

1605 COUNTY LINE RD APT C205
LONGMONT CO
80504-8547
US

V. Phone/Fax

Practice location:
  • Phone: 720-927-1455
  • Fax:
Mailing address:
  • Phone: 720-709-0906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0024912
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: