Provider Demographics
NPI:1770758138
Name:SENIOR, LENORE A (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:LENORE
Middle Name:A
Last Name:SENIOR
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 COLORADO AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-2008
Mailing Address - Country:US
Mailing Address - Phone:719-252-0433
Mailing Address - Fax:
Practice Address - Street 1:509 COLORADO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-2008
Practice Address - Country:US
Practice Address - Phone:719-252-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC4570101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicaid