Provider Demographics
NPI:1629228341
Name:LORI HINZE, PC
Entity Type:Organization
Organization Name:LORI HINZE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:HINZE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:719-314-7623
Mailing Address - Street 1:7222 COMMERCE CENTER DR
Mailing Address - Street 2:SUIE 132
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2652
Mailing Address - Country:US
Mailing Address - Phone:719-314-7623
Mailing Address - Fax:719-309-1295
Practice Address - Street 1:5376 TOMAH DR STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6967
Practice Address - Country:US
Practice Address - Phone:719-278-8490
Practice Address - Fax:719-528-2462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3959251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health