Healthcare Provider Details

I. General information

NPI: 1104275841
Provider Name (Legal Business Name): ERIE COLORADO COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 W LAUREL GLEN PATH
HERNANDO FL
34442-6301
US

IV. Provider business mailing address

1687 W LAUREL GLEN PATH
HERNANDO FL
34442-6301
US

V. Phone/Fax

Practice location:
  • Phone: 720-504-9444
  • Fax:
Mailing address:
  • Phone: 720-504-9444
  • Fax: 303-997-8276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number3669
License Number StateCO

VIII. Authorized Official

Name: DR. JODI J DE LUCA
Title or Position: OWNER
Credential: PHD
Phone: 720-504-9444