Individual
ELISABETH (LISA) COLLINGRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS MFT
Contact information
Practice address
4522 CAPTAIN JACK LN, COLORADO SPRINGS, CO 80924-8219
(617) 599-0104
Mailing address
4522 CAPTAIN JACK LN, COLORADO SPRINGS, CO 80924-8219
(617) 599-0104
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0014159
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014159
MFTC LICENSE NUMBER
CO
Enumeration date
10/22/2021
Last updated
10/22/2021
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