Healthcare Provider Details

I. General information

NPI: 1093679813
Provider Name (Legal Business Name): COLORADO CHRISTIAN UNIVERSITY COMMUNITY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 KELLY JOHNSON BLVD STE 105
COLORADO SPRINGS CO
80920-3930
US

IV. Provider business mailing address

1125 KELLY JOHNSON BLVD STE 105
COLORADO SPRINGS CO
80920-3930
US

V. Phone/Fax

Practice location:
  • Phone: 719-867-5805
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. TRENTON LANGHOFER
Title or Position: OWNER
Credential:
Phone: 316-992-3062