MEDICARE: CHRISTINE L SPRAGUE 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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor	6415	CO

General Provider Information

NPI Number	:	1518020866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE L SPRAGUE LPC

Provider Business Mailing Address
First Line	:	600 S CHERRY ST
Second Line	:	SUITE 910
City	:	DENVER
State	:	CO
Zip	:	80246-1702
Country	:	US
Telephone Number	:	303-815-0553
Fax Number	:	303-500-5464

Provider Business Practice Location Address
First Line	:	600 S CHERRY ST
Second Line	:	SUITE 910
City	:	DENVER
State	:	CO
Zip	:	80246-1702
Country	:	US
Telephone Number	:	303-815-0553
Fax Number	:	303-500-5464

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	01/22/2016

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