Provider Demographics
NPI:1184639536
Name:GRACZ, LOIS CHRISTINE (LPC)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:CHRISTINE
Last Name:GRACZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6290 LEHMAN DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1471
Mailing Address - Country:US
Mailing Address - Phone:719-528-2426
Mailing Address - Fax:719-265-9314
Practice Address - Street 1:6290 LEHMAN DR
Practice Address - Street 2:SUITE 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1471
Practice Address - Country:US
Practice Address - Phone:719-528-2426
Practice Address - Fax:719-265-9314
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO080888Medicaid