Provider Demographics
NPI:1255831392
Name:MCKITTRICK, CHRISTOPHER WREN (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WREN
Last Name:MCKITTRICK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 S SHIELDS ST STE 1K
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1855
Mailing Address - Country:US
Mailing Address - Phone:970-430-6370
Mailing Address - Fax:
Practice Address - Street 1:2519 S SHIELDS ST STE 1K
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1855
Practice Address - Country:US
Practice Address - Phone:970-430-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1872101YP2500X
COLPC.0019043101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional