Healthcare Provider Details

I. General information

NPI: 1427973056
Provider Name (Legal Business Name): MARIA THERESA NIEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 HOLLOW BROOK DR STE 100
COLORADO SPRINGS CO
80918-1443
US

IV. Provider business mailing address

10356 CASTOR DR
COLORADO SPRINGS CO
80925-1432
US

V. Phone/Fax

Practice location:
  • Phone: 719-249-0984
  • Fax:
Mailing address:
  • Phone: 720-413-0451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0009927849
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: