Provider Demographics
NPI:1013894203
Name:AVALOS, TAMICA (LPCC)
Entity type:Individual
Prefix:
First Name:TAMICA
Middle Name:
Last Name:AVALOS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-8902
Mailing Address - Country:US
Mailing Address - Phone:970-964-2763
Mailing Address - Fax:
Practice Address - Street 1:12220 HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-8902
Practice Address - Country:US
Practice Address - Phone:970-964-2763
Practice Address - Fax:833-423-7002
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022886101YM0800X
COACD.0002801101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health