Provider Demographics
NPI:1871117374
Name:LARIVIERE CREATIVE COUNSELING
Entity type:Organization
Organization Name:LARIVIERE CREATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LARIVIERE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-425-8911
Mailing Address - Street 1:5145 N ACADEMY BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4051
Mailing Address - Country:US
Mailing Address - Phone:719-425-8911
Mailing Address - Fax:
Practice Address - Street 1:5145 N ACADEMY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4051
Practice Address - Country:US
Practice Address - Phone:719-425-8911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty