MEDICARE: ERIN GIVEANS MA, 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.0002375	CO

General Provider Information

NPI Number	:	1376034496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN GIVEANS MA, LPC

Provider Business Mailing Address
First Line	:	5236 STRAUSS CABIN RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-9555
Country	:	US
Telephone Number	:	720-422-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 W SOUTH 1ST ST
Second Line	:
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-9086
Country	:	US
Telephone Number	:	720-422-4120
Fax Number	:

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

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	05/24/2018

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