MEDICARE: AUTUMNE CHRISHAUNA GOOD-HINTON MA, NCC, 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	101YP2500X	Professional Counselor	LPC.0013270	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841740396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMNE CHRISHAUNA GOOD-HINTON MA, NCC, LPC

Provider Business Mailing Address
First Line	:	6805 CORPORATE DRIVE
Second Line	:	SUITE 120
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-1977
Country	:	US
Telephone Number	:	719-695-0397
Fax Number	:	719-631-0699

Provider Business Practice Location Address
First Line	:	6805 CORPORATE DRIVE
Second Line	:	SUITE 120
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-1977
Country	:	US
Telephone Number	:	719-695-0397
Fax Number	:	719-631-0699

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

Provider Enumeration Date	:	10/08/2016
Last Update Date	:	12/22/2021

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