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General NPI Number Information
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NPI Number | 1659935567
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Entity Type | Individual
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Provider Name | CHRISTINE GILL MA, LPC, LAC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 3595 S TELLER ST
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City | LAKEWOOD
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State | CO
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Zip | 80235-2014
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Country | US
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Telephone | 720-462-9224
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Fax |
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Provider Business Mailing Address
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Address Line | 4851 INDEPENDENCE ST
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City | WHEAT RIDGE
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State | CO
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Zip | 80033-6715
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Country | US
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Telephone | 720-462-9224
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACB.0008475
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0001545
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0018258
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License Number State | CO
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