Ione Renee Lafata
Individual provider Active NPI Counseling Psychologist · Divide, CO
NPI 1366066110 · NPPES record last updated Jun 7, 2020
Key facts
- NPI
- 1366066110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- NLC.0111058 (CO)
- Practice address
- 31 Spruce Lake Dr
Divide, CO 80814-9757 - Phone
- (719) 900-8894
- NPI assigned
- Jun 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NLC.0111058 | CO | MD | Group Psychotherapy Psychologist |
| IMFT0003 | GU | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Group Psychotherapy Psychologist |
103TP2701X | NLC.0111058 | CO | |
| Cognitive & Behavioral Psychologist |
103TB0200X | NLC.0111058 | CO | |
| School Psychologist |
103TS0200X | NLC.0111058 | CO | |
| Marriage & Family Therapist | 106H00000X | IMFT0003 | GU | |
| Counseling Psychologist | 103TC1900X | NLC.0111058 | CO | Yes |
Addresses
Primary practice location
31 Spruce Lake Dr
Divide, CO 80814-9757
Mailing address
31 Spruce Lake Dr
Divide, CO 80814-9757
Phone (719) 900-8894
Other providers in Divide, CO
- Carol Flowers
- Kathy Marie Hall
- Richard D Haugen
- Martha Diane Hubbard
- Stacey Knapp
- Christina Lesea
- Lisa Lior Lima
- Cheryl Maniak
- Jennifer L McCarthy
- Roy McMurtry
All providers in Divide, CO · Counseling Psychologist in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.