Provider Demographics
NPI:1477086072
Name:SJOBERG, LENORE L (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:L
Last Name:SJOBERG
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:HECKMAN
Other - Middle Name:L
Other - Last Name:LENORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LAC
Mailing Address - Street 1:8085 CAMFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7018
Mailing Address - Country:US
Mailing Address - Phone:719-337-1240
Mailing Address - Fax:
Practice Address - Street 1:8085 CAMFIELD CIR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7018
Practice Address - Country:US
Practice Address - Phone:719-337-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CO13769101YP2500X
CO0013769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000175568Medicaid