Healthcare Provider Details

I. General information

NPI: 1508099292
Provider Name (Legal Business Name): ALPINE SPRINGS COUNSELING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 GRAND AVE
GLENWOOD SPRINGS CO
81601-3808
US

IV. Provider business mailing address

PO BOX 1983
GLENWOOD SPRINGS CO
81602-1983
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-7858
  • Fax: 970-945-2475
Mailing address:
  • Phone: 970-945-7858
  • Fax: 970-945-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT S STARK
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 970-945-7858