Provider Demographics
NPI:1619417623
Name:CROFT, CHAD (LPC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:CROFT
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 1:6275 HEMMINGWAY RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80928-9301
Mailing Address - Country:US
Mailing Address - Phone:719-231-3291
Mailing Address - Fax:
Practice Address - Street 1:6275 HEMMINGWAY RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80928-9301
Practice Address - Country:US
Practice Address - Phone:719-231-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health