Provider Demographics
NPI:1073670964
Name:LEMMON, L. CARLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:L.
Middle Name:CARLA
Last Name:LEMMON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E WILLAMETTE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-4944
Mailing Address - Country:US
Mailing Address - Phone:719-635-7638
Mailing Address - Fax:719-635-1828
Practice Address - Street 1:19 E WILLAMETTE AVE
Practice Address - Street 2:# A
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-4944
Practice Address - Country:US
Practice Address - Phone:719-635-7638
Practice Address - Fax:719-635-1828
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical