Provider Demographics
NPI:1407051204
Name:ESPINOSA, EUGENE (LPC, CACIII,NCC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:LPC, CACIII,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 W CARMEL CT
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-6092
Mailing Address - Country:US
Mailing Address - Phone:719-251-4448
Mailing Address - Fax:
Practice Address - Street 1:CROSSROADS TURNING POINTS, INC
Practice Address - Street 2:3470 BALTIMORE AVE
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008
Practice Address - Country:US
Practice Address - Phone:719-545-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5928101YA0400X
CO3336101YP2500X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility