Healthcare Provider Details

I. General information

NPI: 1205423787
Provider Name (Legal Business Name): RUNNING STREAM COUNSELING SERVICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18425 PONY EXPRESS DR UNIT 203
PARKER CO
80134-9605
US

IV. Provider business mailing address

18425 PONY EXPRESS DR UNIT 203
PARKER CO
80134-9605
US

V. Phone/Fax

Practice location:
  • Phone: 303-805-1218
  • Fax: 303-805-3679
Mailing address:
  • Phone: 303-805-1218
  • Fax: 303-805-3679

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 Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHARON GRIFFIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-805-1218