Healthcare Provider Details

I. General information

NPI: 1609737220
Provider Name (Legal Business Name): SQUARE MUSIC COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 VICKERS DR
COLORADO SPRINGS CO
80918-1981
US

IV. Provider business mailing address

2332 VICKERS DR
COLORADO SPRINGS CO
80918-1981
US

V. Phone/Fax

Practice location:
  • Phone: 719-345-2887
  • Fax:
Mailing address:
  • Phone: 719-345-2887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ELISE JOHNSON
Title or Position: MUSIC THERAPY DIRECTOR
Credential: MA, MT-BC
Phone: 719-345-2887