Provider Demographics
NPI:1457021495
Name:LAMERS, TRACEY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:ANN
Last Name:LAMERS
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 1:2760 29TH ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1221
Mailing Address - Country:US
Mailing Address - Phone:720-583-3593
Mailing Address - Fax:
Practice Address - Street 1:2760 29TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1221
Practice Address - Country:US
Practice Address - Phone:720-583-3593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health