MEDICARE: MR. DAVID L MEANS LPC, QHMP

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
2	101YP2500X	Professional Counselor	C1778	OR

General Provider Information

NPI Number	:	1457417032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID L MEANS LPC, QHMP

Provider Business Mailing Address
First Line	:	3595 E FOUNTAIN BLVD STE 125
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-1734
Country	:	US
Telephone Number	:	719-284-1898
Fax Number	:	719-284-1899

Provider Business Practice Location Address
First Line	:	3595 E FOUNTAIN BLVD STE 125
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-1734
Country	:	US
Telephone Number	:	719-284-1898
Fax Number	:	719-284-1899

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	09/27/2022

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