Provider Demographics
NPI:1972696201
Name:BOUCHE', LAUREN LEE (LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LEE
Last Name:BOUCHE'
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 1:258 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80603-9715
Mailing Address - Country:US
Mailing Address - Phone:303-807-0267
Mailing Address - Fax:303-655-0730
Practice Address - Street 1:360 S MONROE ST
Practice Address - Street 2:STE 310
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3705
Practice Address - Country:US
Practice Address - Phone:303-807-0267
Practice Address - Fax:303-655-0730
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional