MEDICARE: LYNDSEY KLEMME LPC, LAC, NCC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0001103	CO
2	101YP2500X	Professional Counselor	LPC.0014961	CO

General Provider Information

NPI Number	:	1629632542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDSEY KLEMME LPC, LAC, NCC

Provider Business Mailing Address
First Line	:	1556 N WILLIAMS ST UNIT 101
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1661
Country	:	US
Telephone Number	:	303-437-2087
Fax Number	:

Provider Business Practice Location Address
First Line	:	1556 N WILLIAMS ST UNIT 101
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1661
Country	:	US
Telephone Number	:	303-437-2087
Fax Number	:	303-863-0835

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

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	01/10/2022

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