Healthcare Provider Details

I. General information

NPI: 1124153135
Provider Name (Legal Business Name): JAMES DALE SAUNDERS LPC, LAC, MAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E PIKES PEAK AVE
COLORADO SPRINGS CO
80903-3635
US

IV. Provider business mailing address

825 E PIKES PEAK AVE
COLORADO SPRINGS CO
80903-3635
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-8487
  • Fax: 719-776-8726
Mailing address:
  • Phone: 719-776-8487
  • Fax: 719-776-8726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLAC-121
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC 3514
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: