MEDICARE: MS. LAURA GARRETT LPC NCC CACIII

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	4144	CO
2	101YP2500X	Professional Counselor	1101	CO

General Provider Information

NPI Number	:	1942335757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA GARRETT LPC NCC CACIII

Provider Business Mailing Address
First Line	:	8546 SEATLE SLEW LN
Second Line	:
City	:	WELLINGTON
State	:	CO
Zip	:	80549-3234
Country	:	US
Telephone Number	:	970-420-4526
Fax Number	:

Provider Business Practice Location Address
First Line	:	3527 CLEVELAND AVE
Second Line	:
City	:	WELLINGTON
State	:	CO
Zip	:	80549-1500
Country	:	US
Telephone Number	:	970-420-4526
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	06/30/2008

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