Healthcare Provider Details

I. General information

NPI: 1780431551
Provider Name (Legal Business Name): REBECCA CARPENTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 FALL RIVER DR STE 250
LOVELAND CO
80538-7158
US

IV. Provider business mailing address

2860 S CIRCLE DR STE 109
COLORADO SPRINGS CO
80906-4195
US

V. Phone/Fax

Practice location:
  • Phone: 888-374-5066
  • Fax: 719-623-0165
Mailing address:
  • Phone: 888-374-5066
  • Fax: 719-623-0165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: