Individual
CARMEN LOUISE SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
606 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-2779
(303) 523-8057
(303) 772-0629
Mailing address
606 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-2779
(303) 523-8057
(303) 772-0629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
249
CO
1041C0700X
Clinical Social Worker
Primary
1736
CO
Other
Enumeration date
11/24/2009
Last updated
11/14/2025
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