MEDICARE: LINDSEY LANDGREBE PHP

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	6270	CO

General Provider Information

NPI Number	:	1346095452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY LANDGREBE PHP

Provider Business Mailing Address
First Line	:	1641 S PATTON CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-4460
Country	:	US
Telephone Number	:	217-622-3634
Fax Number	:

Provider Business Practice Location Address
First Line	:	1641 S PATTON CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-4460
Country	:	US
Telephone Number	:	217-622-3634
Fax Number	:

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

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	04/22/2024

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Directions to “ LINDSEY LANDGREBE PHP” Practice Location

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