Provider Demographics
NPI:1336434695
Name:KORBITZ, LINDSEY JENIFER (LPC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JENIFER
Last Name:KORBITZ
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 1:1420 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-2005
Mailing Address - Country:US
Mailing Address - Phone:719-980-1195
Mailing Address - Fax:
Practice Address - Street 1:1420 E 3RD ST
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-2005
Practice Address - Country:US
Practice Address - Phone:719-980-1195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional