MEDICARE: CARLI TORR 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	101YM0800X	Mental Health Counselor		CO
2	101YP2500X	Professional Counselor	LPC.0014641	CO

General Provider Information

NPI Number	:	1114565082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLI TORR LPC

Provider Business Mailing Address
First Line	:	15455 GLENEAGLE DR STE 210
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-2593
Country	:	US
Telephone Number	:	917-671-6419
Fax Number	:

Provider Business Practice Location Address
First Line	:	15455 GLENEAGLE DR STE 210
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-2593
Country	:	US
Telephone Number	:	716-419-9176
Fax Number	:

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

Provider Enumeration Date	:	12/11/2019
Last Update Date	:	01/13/2023

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