Provider Demographics
NPI:1750928255
Name:COLLASO, CRISTINA D (CAS)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:D
Last Name:COLLASO
Suffix:
Gender:F
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15670 E MEXICO AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-5001
Mailing Address - Country:US
Mailing Address - Phone:720-907-5242
Mailing Address - Fax:
Practice Address - Street 1:8527 W COLFAX AVE STE 240
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4028
Practice Address - Country:US
Practice Address - Phone:720-907-5242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0108389101Y00000X
COACA.0007581101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1740608959Medicaid