MEDICARE: MR. DEVAN PAUL LIVAUDAIS 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.0023375	CO
2	101Y00000X	Counselor	LPC.0023375	CO
3	101YM0800X	Mental Health Counselor	LPC.0023375	CO

General Provider Information

NPI Number	:	1841053303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEVAN PAUL LIVAUDAIS LPC

Provider Business Mailing Address
First Line	:	2519 S SHIELDS ST STE 1K
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1855
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 MCCLELLAND DR STE 3200
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2572
Country	:	US
Telephone Number	:	970-236-1088
Fax Number	:

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

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	01/30/2026

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