Provider Demographics
NPI:1356653679
Name:STALLINGS, ELIZABETH FAYE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:FAYE
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9132 AVENIDA HERMOSA VW
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-7041
Mailing Address - Country:US
Mailing Address - Phone:719-659-4996
Mailing Address - Fax:
Practice Address - Street 1:10 BOULDER CRESCENT ST STE 203B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3358
Practice Address - Country:US
Practice Address - Phone:719-646-2165
Practice Address - Fax:719-646-2165
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional