| Ms Tina Lorraine Bezona, LPC | |
|
107 S 9th St, Canon City, CO 81212-3800 | |
| (719) 430-5929 | |
| Not Available |
| Full Name | Ms Tina Lorraine Bezona |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 107 S 9th St, Canon City, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003031287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4266 (Colorado) | Primary |
| Entity Name | Sacred Self Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710614102 PECOS PAC ID: 6901242775 Enrollment ID: O20240314003826 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Tina Lorraine Bezona, LPC 1183 S Camino Santiago Dr, Pueblo West, CO 81007-1904 Ph: (719) 651-9301 | Ms Tina Lorraine Bezona, LPC 107 S 9th St, Canon City, CO 81212-3800 Ph: (719) 430-5929 |
Mrs. Verena Johanna Burger Schmid, LPC, CACII Counselor Medicare: Not Enrolled in Medicare Practice Location: 831 Royal Gorge Blvd, Suite #228, Canon City, CO 81212 Phone: 719-248-8093 Fax: 888-242-6614 | |
Lori L. Meffley, MSW, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 303 N 7th St, Canon City, CO 81212 Phone: 719-269-3229 Fax: 719-269-8328 | |
Alan Donald, CAC II Counselor Medicare: Medicare Enrolled Practice Location: 602 Yale Pl, Canon City, CO 81212 Phone: 719-275-0700 | |
Jenifer Papaccio, Counselor Medicare: Medicare Enrolled Practice Location: 3225 Independence Rd, Canon City, CO 81212 Phone: 719-275-2351 | |
Jenifer L Burbank, LPC Counselor Medicare: Medicare Enrolled Practice Location: 303 N 7th St Ste 202, Canon City, CO 81212 Phone: 719-671-1036 Fax: 719-306-0578 | |
Tonya Woodson, BS CACII Counselor Medicare: Not Enrolled in Medicare Practice Location: 3239 Independence Rd, Canon City, CO 81212 Phone: 719-275-7650 |