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NPI 1376420893

NPI 1376420893 : KENNETH GEORGE EBINGER LAC, LPCC : GRAND JUNCTION, CO

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General NPI Number Information
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    NPI Number           |    1376420893
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH GEORGE EBINGER LAC, LPCC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2025
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    Last Update Date     |    08/27/2025
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Provider Practice Location Address
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    Address Line         |    PO BOX 40035 
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    City                 |    GRAND JUNCTION
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    State                |    CO
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    Zip                  |    81504-0035
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    Country              |    US
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    Telephone            |    609-384-1763
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 40035 
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    City                 |    GRAND JUNCTION
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    State                |    CO
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    Zip                  |    81504-0035
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    Country              |    US
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    Telephone            |    609-384-1763
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    LPCC.0023303
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    License Number State |    CO
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    ACD.0002799
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    License Number State |    CO
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