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General NPI Number Information
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NPI Number | 1124745054
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Entity Type | Organization
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Legal Business Name | OPEN GATE COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1201 E 7TH ST STE 202
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City | PUEBLO
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State | CO
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Zip | 81001-3506
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Country | US
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Telephone | 719-744-2326
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 E 7TH ST STE 202
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City | PUEBLO
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State | CO
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Zip | 81001-3506
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Country | US
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Telephone | 719-744-2326
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KAREN C KHATON
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Credential | LPC
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Telephone | 719-744-2326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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