Provider Demographics
NPI:1902516180
Name:CANOSE, LAUREN (MSED, LPCC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:CANOSE
Suffix:
Gender:F
Credentials:MSED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 PERRY ST STE 260
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2487
Mailing Address - Country:US
Mailing Address - Phone:720-295-3314
Mailing Address - Fax:
Practice Address - Street 1:380 PERRY ST STE 260
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2487
Practice Address - Country:US
Practice Address - Phone:720-295-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty