MEDICARE: ALICIA KLINKER M.A., LPC, 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	101Y00000X	Counselor	0018958	CO

General Provider Information

NPI Number	:	1922784693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA KLINKER M.A., LPC, NCC

Provider Business Mailing Address
First Line	:	PO BOX 62861
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80962-2861
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7010 HARR AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80902-2190
Country	:	US
Telephone Number	:	719-321-7141
Fax Number	:

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

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/26/2023

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