Provider Demographics
NPI:1073882718
Name:PAHL, LORI ANN (LPC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:PAHL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:PAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1992 SUGARBUSH DR
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9489
Mailing Address - Country:US
Mailing Address - Phone:970-580-6718
Mailing Address - Fax:
Practice Address - Street 1:1992 SUGARBUSH DR
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9489
Practice Address - Country:US
Practice Address - Phone:705-806-7189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional