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General NPI Number Information
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NPI Number | 1720135460
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Entity Type | Individual
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Provider Name | EVA L TALBOTT MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 115 S PARKSIDE DRIVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910
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Country | US
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Telephone | 719-572-6340
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Fax | 719-447-4792
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Provider Business Mailing Address
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Address Line | 220 RUSKIN DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910
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Country | US
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Telephone | 719-572-6100
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Fax | 719-572-6080
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4413
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1677
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License Number State | CO
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