Healthcare Provider Details

I. General information

NPI: 1619341153
Provider Name (Legal Business Name): SUMMIT COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10285 FEDERAL DR
COLORADO SPRINGS CO
80908-4510
US

IV. Provider business mailing address

19 AVOCET LOOP
COLORADO SPRINGS CO
80921-2455
US

V. Phone/Fax

Practice location:
  • Phone: 406-590-9177
  • Fax:
Mailing address:
  • Phone: 406-590-9176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC237723-1432791
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL R SKAGGS
Title or Position: OWENER
Credential: LCPC
Phone: 406-590-9176