Provider Demographics
NPI:1356728729
Name:HOLABECK, PATRICIA ELAINE (MA, LPCC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELAINE
Last Name:HOLABECK
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6047 WHETSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-7549
Mailing Address - Country:US
Mailing Address - Phone:719-428-9284
Mailing Address - Fax:
Practice Address - Street 1:333 PERRY ST STE 206E
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2434
Practice Address - Country:US
Practice Address - Phone:719-428-9284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO112100371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health