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NPI Code Detail

MEDICARE: PETER KARDASIS MA, LAC, LPCC

MEDICARE: PETER KARDASIS MA, LAC, LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorACD.0002898CO

General Provider Information

NPI Number : 1144171570
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER KARDASIS MA, LAC, LPCC
Provider Business Mailing Address
First Line : 2833 ANNELISE WAY
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7628
Country : US
Telephone Number : 415-308-6460
Fax Number :
Provider Business Practice Location Address
First Line : 1644 S COLLEGE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-1007
Country : US
Telephone Number : 970-221-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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