Healthcare Provider Details

I. General information

NPI: 1871980821
Provider Name (Legal Business Name): LISA TOWNSEND PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA TOWNSEND PSYD

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6760 CORPORATE DR STE 210
COLORADO SPRINGS CO
80919-1987
US

IV. Provider business mailing address

6760 CORPORATE DR STE 210
COLORADO SPRINGS CO
80919-1987
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-5528
  • Fax: 719-635-7187
Mailing address:
  • Phone: 719-635-5528
  • Fax: 719-635-7187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0004219
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number0004219
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number0004219
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number0004219
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: