Provider Demographics
NPI:1427304039
Name:ANDERSON, CHRISTINA S (LPC, ATR)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:S
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 DTC PKWY STE G
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3010
Mailing Address - Country:US
Mailing Address - Phone:720-593-1132
Mailing Address - Fax:720-815-3341
Practice Address - Street 1:5310 DTC PKWY STE G
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3010
Practice Address - Country:US
Practice Address - Phone:720-593-1132
Practice Address - Fax:720-815-3341
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2134101YP2500X
CO0013616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
14101674OtherCAQH
CO85478Medicaid