Healthcare Provider Details

I. General information

NPI: 1427412386
Provider Name (Legal Business Name): COLLEEN RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S CASCADE AVE
COLORADO SPRINGS CO
80903-4039
US

IV. Provider business mailing address

5022 HAWK MEADOW DR
COLORADO SPRINGS CO
80916-5729
US

V. Phone/Fax

Practice location:
  • Phone: 970-581-9790
  • Fax:
Mailing address:
  • Phone: 970-581-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: