Active NPI
Christine R Chavez, PSYD, LPC
- Mental Health Counselor
- Colorado Springs, CO
National Provider Identifier
1114264389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11191
- Practice address
- 422 E Vermijo Ave Ste 206
Colorado Springs, CO 80903-3778 - Phone
- (719) 358-1721
- Fax
- (719) 309-0731
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11191 | CO | Primary |
Addresses
Primary practice location
422 E Vermijo Ave Ste 206
Colorado Springs, CO 80903-3778
Mailing address
1067 E US Highway 24 # 294
Woodland Park, CO 80863-2120
Phone (719) 358-1721
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15621839 | Medicaid | CO | |
| 12529685 | Other | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11191 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1114264389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1067 E US HIGHWAY 24 # 294",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "808632120",
"telephone_number": "719-358-1721",
"fax_number": "719-309-0731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 E VERMIJO AVE STE 206",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809033778",
"telephone_number": "719-358-1721",
"fax_number": "719-309-0731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "CHRISTINE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSYD, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "11191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15621839",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12529685",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.