Healthcare Provider Details

I. General information

NPI: 1306667167
Provider Name (Legal Business Name): HIGH ROCKIES COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 E RAINBOW BLVD
SALIDA CO
81201-2519
US

IV. Provider business mailing address

245 E RAINBOW BLVD
SALIDA CO
81201-2519
US

V. Phone/Fax

Practice location:
  • Phone: 719-239-0747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: GINA PORTER
Title or Position: OWNER/LPC
Credential: LPC
Phone: 719-239-0747