Provider Demographics
NPI:1609337203
Name:CARBONE, MAURICIO GABRIEL (LPCC)
Entity Type:Individual
Prefix:
First Name:MAURICIO
Middle Name:GABRIEL
Last Name:CARBONE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8407 ARAPAHOE PEAK ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-8464
Mailing Address - Country:US
Mailing Address - Phone:720-630-1285
Mailing Address - Fax:
Practice Address - Street 1:14901 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5065
Practice Address - Country:US
Practice Address - Phone:720-630-1285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016542101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLPC.0016542OtherSTATE OF COLORADO