MEDICARE: CRISTINA LEE COLBURN LPC, CRC

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	101YM0800X	Mental Health Counselor	CC05163	MN
2	101YM0800X	Mental Health Counselor	132941	IA
3	101YP2500X	Professional Counselor	MH30946	SD

General Provider Information

NPI Number	:	1942044243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA LEE COLBURN LPC, CRC

Provider Business Mailing Address
First Line	:	7900 E ARROWHEAD PKWY APT 228
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-7017
Country	:	US
Telephone Number	:	605-212-9975
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 W 41ST ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-3012
Country	:	US
Telephone Number	:	605-504-0400
Fax Number	:

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

Provider Enumeration Date	:	06/21/2024
Last Update Date	:	09/18/2025

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