Provider Demographics
NPI:1871980821
Name:TOWNSEND, LISA (PSYD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:101 N CASCADE AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1410
Mailing Address - Country:US
Mailing Address - Phone:719-635-5528
Mailing Address - Fax:719-448-9467
Practice Address - Street 1:101 N CASCADE AVE
Practice Address - Street 2:STE 4
Practice Address - City:COLORADO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:719-635-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-16
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004219103TA0700X, 103TB0200X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0004219OtherCOLORADO LICENSED PSYCHOLOGIST