Healthcare Provider Details

I. General information

NPI: 1598985376
Provider Name (Legal Business Name): RHONDA CELESTE HERN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RHONDA CELESTE FORSYTH MA

II. Dates (important events)

Enumeration Date: 04/26/2007
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 Number5290
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: