Provider Demographics
NPI:1023233186
Name:ZELLER, FREDRIC DEVORE (LPC)
Entity type:Individual
Prefix:MR
First Name:FREDRIC
Middle Name:DEVORE
Last Name:ZELLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:RIC
Other - Middle Name:
Other - Last Name:ZELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:5126 STONE FENCE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5126 STONE FENCE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-3641
Practice Address - Country:US
Practice Address - Phone:719-482-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4286101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional