MEDICARE: LAURA PAGE HALL 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LPC.0006128	CO
2	101YM0800X	Mental Health Counselor	LPC.0006128	CO
3	101YP2500X	Professional Counselor	LPC.0006128	CO

General Provider Information

NPI Number	:	1841424264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA PAGE HALL LPC

Provider Business Mailing Address
First Line	:	2925 PROFESSIONAL PL STE 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-8125
Country	:	US
Telephone Number	:	719-776-6850
Fax Number	:	719-776-6855

Provider Business Practice Location Address
First Line	:	2925 PROFESSIONAL PL STE 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-8125
Country	:	US
Telephone Number	:	719-776-6850
Fax Number	:	719-776-6855

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

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	10/28/2021

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Directions to “ LAURA PAGE HALL LPC” Practice Location

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