Provider Demographics
NPI:1396436861
Name:VLASTOS, ZOE E (LPC)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:E
Last Name:VLASTOS
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 1:850 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2440
Mailing Address - Country:US
Mailing Address - Phone:314-413-4626
Mailing Address - Fax:
Practice Address - Street 1:850 36TH ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2440
Practice Address - Country:US
Practice Address - Phone:314-413-4626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health