MEDICARE: BARBARA M VONDERHARR PHD, LPC, LAC

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	101YP2500X	Professional Counselor	LPC016653	GA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0002108	CO

General Provider Information

NPI Number	:	1720547169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA M VONDERHARR PHD, LPC, LAC

Provider Business Mailing Address
First Line	:	11177 HAHN RD
Second Line	:
City	:	CALHAN
State	:	CO
Zip	:	80808-9212
Country	:	US
Telephone Number	:	719-632-3510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2565 AIRPORT RD
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80910-3119
Country	:	US
Telephone Number	:	719-632-3510
Fax Number	:

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

Provider Enumeration Date	:	03/15/2019
Last Update Date	:	06/03/2026

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