Healthcare Provider Details

I. General information

NPI: 1992517775
Provider Name (Legal Business Name): OVERCOMERS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W MULBERRY ST STE 108
FORT COLLINS CO
80521-2864
US

IV. Provider business mailing address

5585 ERINDALE DR STE 204
COLORADO SPRINGS CO
80918-6969
US

V. Phone/Fax

Practice location:
  • Phone: 970-698-8778
  • Fax: 855-719-2549
Mailing address:
  • Phone: 719-345-2424
  • Fax: 855-719-2549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LYNN LUTTMAN
Title or Position: LPC, OWNER
Credential:
Phone: 719-345-2424