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Organization

CRISALIDA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLORY MCDANIEL LPC, LAC (EXECUTIVE DIRECTOR)
(303) 519-9218
Entity
Organization

Contact information

Practice address
4180 CENTER PARK DR, COLORADO SPRINGS, CO 80916-4505
(719) 698-8036
Mailing address
4180 CENTER PARK DR, COLORADO SPRINGS, CO 80916-4505
(719) 698-8036

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000171725
CO
Enumeration date
11/04/2025
Last updated
11/04/2025
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