Healthcare Provider Details

I. General information

NPI: 1083533418
Provider Name (Legal Business Name): RUDI LANGE HANEKAMP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N ACADEMY BLVD STE 337
COLORADO SPRINGS CO
80909-1567
US

IV. Provider business mailing address

406 EDGEWOOD DR
COLORADO SPRINGS CO
80907-4510
US

V. Phone/Fax

Practice location:
  • Phone: 719-357-7255
  • Fax:
Mailing address:
  • Phone: 307-399-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0023996
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: