MEDICARE: CHERI TRAHAN KEENE LPC

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
1	103TC1900X	Counseling Psychologist	75343	TX
2	103TC1900X	Counseling Psychologist	0015929	CO

General Provider Information

NPI Number	:	1073086484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERI TRAHAN KEENE LPC

Provider Business Mailing Address
First Line	:	1612 LAPORTE AVE UNIT 11
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2399
Country	:	US
Telephone Number	:	970-682-9339
Fax Number	:

Provider Business Practice Location Address
First Line	:	1612 LAPORTE AVE UNIT 11
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-2399
Country	:	US
Telephone Number	:	970-682-9339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	05/12/2026

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Directions to “ CHERI TRAHAN KEENE LPC” Practice Location

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