MEDICARE: AMBER NICOLE TESCHENDORF 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	101YP2500X	Professional Counselor	89590	TX
2	101YP2500X	Professional Counselor	LPC.0022160	CO

General Provider Information

NPI Number	:	1255126728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER NICOLE TESCHENDORF LPC

Provider Business Mailing Address
First Line	:	630 SOUTHPOINTE CT STE 105
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3800
Country	:	US
Telephone Number	:	281-912-9266
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 VONDELPARK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4054
Country	:	US
Telephone Number	:	281-912-9266
Fax Number	:

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

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	07/17/2025

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