Provider Demographics
NPI:1225468499
Name:ACOSTA, LAURA L (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 LAKE PLAZA DR STE 130
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3581
Mailing Address - Country:US
Mailing Address - Phone:719-357-6175
Mailing Address - Fax:
Practice Address - Street 1:1235 LAKE PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3581
Practice Address - Country:US
Practice Address - Phone:405-448-4028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health