Healthcare Provider Details

I. General information

NPI: 1417864810
Provider Name (Legal Business Name): LAUREN ASHLEY RUNYON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 TOMAH DR STE 3800
COLORADO SPRINGS CO
80918-6957
US

IV. Provider business mailing address

165 STAFFORD CT
COLORADO SPRINGS CO
80904-4824
US

V. Phone/Fax

Practice location:
  • Phone: 719-659-1214
  • Fax:
Mailing address:
  • Phone: 719-216-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: