Individual
MRS. LISA M RUNZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LMFT
Contact information
Practice address
5360 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80918-4006
(719) 227-7477
(719) 227-7474
Mailing address
5360 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80918-4006
(719) 695-0757
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC.0012170
CO
106H00000X
Marriage & Family Therapist
Primary
MFT.0001193
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12665446
CAQH
CO
Enumeration date
10/30/2012
Last updated
05/18/2016
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