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NPI Code Detail

MEDICARE: COLLEEN MARY TODD MA, LPC, CACIII

MEDICARE: COLLEEN MARY TODD MA, LPC, CACIII
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
1101YA0400XAddiction (Substance Use Disorder) Counselor6291CO
2101YP2500XProfessional Counselor4325CO

General Provider Information

NPI Number : 1588829303
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN MARY TODD MA, LPC, CACIII
Provider Business Mailing Address
First Line : 1400 MAIN ST STE 101
Second Line :
City : LOUISVILLE
State : CO
Zip : 80027-3046
Country : US
Telephone Number : 720-684-9845
Fax Number :
Provider Business Practice Location Address
First Line : 1400 MAIN ST STE 101
Second Line :
City : LOUISVILLE
State : CO
Zip : 80027-3046
Country : US
Telephone Number : 720-684-9845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2008
Last Update Date : 10/04/2023

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