Provider Demographics
NPI:1831152891
Name:ALLRED, STEVEN GARY (LCSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:GARY
Last Name:ALLRED
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 N ACADEMY BLVD STE 3300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4082
Mailing Address - Country:US
Mailing Address - Phone:719-200-1815
Mailing Address - Fax:
Practice Address - Street 1:5265 N ACADEMY BLVD STE 3300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4082
Practice Address - Country:US
Practice Address - Phone:719-200-1815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14401041C0700X
UT8054443-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical