MEDICARE: ROCK YOUR FAMILY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101Y00000X	Counselor	LPC.0014064	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	LPC.0014064	OTHER	CO	COUNSELOR

General Provider Information

NPI Number	:	1275024044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK YOUR FAMILY, LLC

Provider Business Mailing Address
First Line	:	1465 KELLY JOHNSON BLVD STE 305
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3947
Country	:	US
Telephone Number	:	719-235-2495
Fax Number	:	719-375-3004

Provider Business Practice Location Address
First Line	:	1465 KELLY JOHNSON BLVD STE 305
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3947
Country	:	US
Telephone Number	:	719-362-0796
Fax Number	:	719-375-3004

Authorized Official
Title or Position	:	OWNER
Name	:	JORDAN HALL
Credential	:	LPC
Telephone Number	:	719-362-0796

Provider Enumeration Date	:	05/28/2018
Last Update Date	:	08/24/2022

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Directions to “ROCK YOUR FAMILY, LLC ” Practice Location

Language	Start Address	Practice Location

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