Provider Demographics
NPI:1740979822
Name:MCCANN, CHRISTINA E (NCC, LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:E
Last Name:MCCANN
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 KIMBARK ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1578
Mailing Address - Country:US
Mailing Address - Phone:303-359-7210
Mailing Address - Fax:
Practice Address - Street 1:1500 KANSAS AVE STE 3F
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6556
Practice Address - Country:US
Practice Address - Phone:303-359-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4132101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional