Provider Demographics
NPI:1952572885
Name:SPENCE, CARLA (LPC)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:
Last Name:SPENCE
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:PO BOX 95
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CO
Mailing Address - Zip Code:80118-0095
Mailing Address - Country:US
Mailing Address - Phone:303-350-2737
Mailing Address - Fax:303-681-2401
Practice Address - Street 1:12163 PERRY PARK RD
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CO
Practice Address - Zip Code:80118
Practice Address - Country:US
Practice Address - Phone:303-350-2737
Practice Address - Fax:303-681-2401
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2084101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional