MEDICARE: CHRISTINA ALLARD LPC, LAC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0000939	CO
2	101YP2500X	Professional Counselor	LPC.0015174	CO

General Provider Information

NPI Number	:	1164813390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ALLARD LPC, LAC

Provider Business Mailing Address
First Line	:	6893 KETCHUM DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-9404
Country	:	US
Telephone Number	:	720-335-8372
Fax Number	:

Provider Business Practice Location Address
First Line	:	6893 KETCHUM DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-9404
Country	:	US
Telephone Number	:	720-335-8372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	05/06/2022

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