MEDICARE: MRS. CHRISTINE INEZ CLAY LMFT

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	106H00000X	Marriage & Family Therapist	695	CO

General Provider Information

NPI Number	:	1417155714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE INEZ CLAY LMFT

Provider Business Mailing Address
First Line	:	3520 AUSTIN BLUFFS PKWY STE 104
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-5756
Country	:	US
Telephone Number	:	719-661-8109
Fax Number	:	719-204-3829

Provider Business Practice Location Address
First Line	:	3520 AUSTIN BLUFFS PKWY STE 104
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-5756
Country	:	US
Telephone Number	:	719-661-8109
Fax Number	:	719-204-3829

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

Provider Enumeration Date	:	07/07/2007
Last Update Date	:	10/24/2025

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