Healthcare Provider Details

I. General information

NPI: 1801333596
Provider Name (Legal Business Name): RANDEE JANELLE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E KIOWA ST
COLORADO SPRINGS CO
80903-1707
US

IV. Provider business mailing address

10096 KINGSBURY DR
PEYTON CO
80831-7168
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-7815
  • Fax:
Mailing address:
  • Phone: 719-749-1675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17601
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4891
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16997
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4891
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: