Provider Demographics
NPI:1043074248
Name:FACUNDO, KARA (LPC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:FACUNDO
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 1:4411 CAPTAIN JACK LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-8214
Mailing Address - Country:US
Mailing Address - Phone:719-201-9561
Mailing Address - Fax:
Practice Address - Street 1:4411 CAPTAIN JACK LN
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-8214
Practice Address - Country:US
Practice Address - Phone:719-201-9561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0020240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health