Provider Demographics
NPI:1093909053
Name:HINZE, LORI ELLEN (MA, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ELLEN
Last Name:HINZE
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5376 TOMAH DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6739
Mailing Address - Country:US
Mailing Address - Phone:719-278-8490
Mailing Address - Fax:719-528-2462
Practice Address - Street 1:5376 TOMAH DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6739
Practice Address - Country:US
Practice Address - Phone:719-278-8490
Practice Address - Fax:719-528-2462
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3959101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional