Healthcare Provider Details

I. General information

NPI: 1336834266
Provider Name (Legal Business Name): MELISSA BAUMGARTNER MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 PARKMOOR VILLAGE DR STE 102
COLORADO SPRINGS CO
80917-5200
US

IV. Provider business mailing address

3715 PARKMOOR VILLAGE DR STE 102
COLORADO SPRINGS CO
80917-5200
US

V. Phone/Fax

Practice location:
  • Phone: 719-540-2127
  • Fax:
Mailing address:
  • Phone: 719-452-4803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0019179
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: