Provider Demographics
NPI:1548092893
Name:COLCLAZIER, JAMES LOGAN (LPCC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LOGAN
Last Name:COLCLAZIER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 TWIN OAKS DR APT 1167
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3258
Mailing Address - Country:US
Mailing Address - Phone:405-627-6728
Mailing Address - Fax:
Practice Address - Street 1:6430 BROOK PARK DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1432
Practice Address - Country:US
Practice Address - Phone:855-961-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional