Healthcare Provider Details

I. General information

NPI: 1639844707
Provider Name (Legal Business Name): TARA DANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 HUNTERS RIDGE DR
COLORADO SPRINGS CO
80919-7949
US

IV. Provider business mailing address

1065 HUNTERS RIDGE DR
COLORADO SPRINGS CO
80919-7949
US

V. Phone/Fax

Practice location:
  • Phone: 719-900-1454
  • Fax:
Mailing address:
  • Phone: 540-422-3768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0020876
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: