Healthcare Provider Details

I. General information

NPI: 1598431736
Provider Name (Legal Business Name): SONDRA RANER COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/28/2021
Certification Date: 08/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 W 12TH ST
GREELEY CO
80634-8864
US

IV. Provider business mailing address

7702 W 12TH ST
GREELEY CO
80634-8864
US

V. Phone/Fax

Practice location:
  • Phone: 970-545-9133
  • Fax:
Mailing address:
  • Phone: 970-545-9133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SONDRA DOLORIS RANER
Title or Position: OWNER
Credential: LCSW, LAC
Phone: 970-545-9133