Healthcare Provider Details

I. General information

NPI: 1457991606
Provider Name (Legal Business Name): LIFEPATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2641 SOUTHPARK RD
FLORISSANT CO
80816-8991
US

IV. Provider business mailing address

1067 E US HIGHWAY 24 # 171
WOODLAND PARK CO
80863-2120
US

V. Phone/Fax

Practice location:
  • Phone: 719-465-7442
  • Fax: 719-960-2279
Mailing address:
  • Phone: 719-465-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RHONDA CELESTE HERN
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LPC
Phone: 719-465-7442