MEDICARE: KARLI HAUGOM LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0016319	CO

General Provider Information

NPI Number	:	1164079604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLI HAUGOM LPC

Provider Business Mailing Address
First Line	:	712 MEADE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	712 MEADE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3020
Country	:	US
Telephone Number	:	970-371-9981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2019
Last Update Date	:	11/18/2020

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Directions to “ KARLI HAUGOM LPC” Practice Location

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