Healthcare Provider Details

I. General information

NPI: 1487576781
Provider Name (Legal Business Name): EM KAI MAIS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 RANGEWOOD DR STE 130
COLORADO SPRINGS CO
80920-2100
US

IV. Provider business mailing address

7560 RANGEWOOD DR STE 130
COLORADO SPRINGS CO
80920-2100
US

V. Phone/Fax

Practice location:
  • Phone: 719-725-1987
  • Fax: 888-425-0383
Mailing address:
  • Phone: 719-725-1987
  • Fax: 888-425-0383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0024108
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: