Provider Demographics
NPI:1992835615
Name:DELOUX, EUGENE R (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:R
Last Name:DELOUX
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:MR
Other - First Name:GENE
Other - Middle Name:
Other - Last Name:DELOUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:5875 LEHMAN DR STE 103
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3466
Mailing Address - Country:US
Mailing Address - Phone:719-264-0054
Mailing Address - Fax:719-598-9254
Practice Address - Street 1:5875 LEHMAN DR STE 103
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3466
Practice Address - Country:US
Practice Address - Phone:719-264-0054
Practice Address - Fax:719-598-9254
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional