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NPI Code Detail

MEDICARE: MR. STEVEN GARY ALLRED LCSW

MEDICARE: MR. STEVEN GARY ALLRED LCSW
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
11041C0700XClinical Social Worker1440CO
21041C0700XClinical Social Worker8054443-3501UT

General Provider Information

NPI Number : 1831152891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN GARY ALLRED LCSW
Provider Business Mailing Address
First Line : 5265 N ACADEMY BLVD STE 3300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4082
Country : US
Telephone Number : 719-200-1815
Fax Number :
Provider Business Practice Location Address
First Line : 5265 N ACADEMY BLVD STE 3300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4082
Country : US
Telephone Number : 719-200-1815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 10/06/2011

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