MEDICARE: STEPHEN PATRICK FLANSBAUM LMHC

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	103K00000X	Behavior Analyst
2	101YP2500X	Professional Counselor	LH60526071	WA

General Provider Information

NPI Number	:	1104220987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN PATRICK FLANSBAUM LMHC

Provider Business Mailing Address
First Line	:	2310 W MONUMENT ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-2667
Country	:	US
Telephone Number	:	425-409-2368
Fax Number	:

Provider Business Practice Location Address
First Line	:	2310 W MONUMENT ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-2667
Country	:	US
Telephone Number	:	425-409-2368
Fax Number	:

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

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	07/10/2024

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