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NPI Code Detail

MEDICARE: MRS. CHRISTINA JANISZESKI LPC, LAC

MEDICARE: MRS. CHRISTINA JANISZESKI 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
1101YA0400XAddiction (Substance Use Disorder) CounselorACD.0001337CO
2101YP2500XProfessional CounselorLPC.0014963CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ACD.0001337OTHERCODEPARTMENT OF REGULATORY AGENCIES
2LPC.0014963OTHERCODEPARTMENT OF REGULATORY AGENCIES

General Provider Information

NPI Number : 1033657770
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA JANISZESKI LPC, LAC
Provider Business Mailing Address
First Line : 5360 N ACADEMY BLVD STE 290
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4038
Country : US
Telephone Number : 719-434-2061
Fax Number : 719-434-2275
Provider Business Practice Location Address
First Line : 5360 N ACADEMY BLVD STE 290
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4038
Country : US
Telephone Number : 719-434-2061
Fax Number : 719-434-2275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2017
Last Update Date : 09/20/2019

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Directions to “ MRS. CHRISTINA JANISZESKI LPC, LAC” Practice Location

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