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Provider Information for 1811006687


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Ms. TERESA LOUISE STARCK LPC


Other Names:  
Former Name: 
TERESA LOUISE COLE LPC

Sex: Female

NPI: 1811006687
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1811006687
Enumeration Date2006-08-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 4601 CORBETT DR
FORT COLLINS, CO 80528-9579
United States

Phone: 970-207-4800 | Fax:970-207-4805
 
Primary Practice Address 4601 CORBETT DR
FORT COLLINS, CO 80528-9579
United States

Phone: 970-207-4800 | Fax:970-207-4805
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCO22686045
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalCO1770