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General NPI Number Information
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NPI Number | 1215715461
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Entity Type | Organization
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Legal Business Name | COLORS OF YOU COUNSELING AND CONSULTING PLLC
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1931 NEW GARDEN RD STE 204
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City | GREENSBORO
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State | NC
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Zip | 27410-2558
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Country | US
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Telephone | 919-391-0122
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Fax | 919-289-1758
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Provider Business Mailing Address
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Address Line | 1931 NEW GARDEN RD STE 204
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City | GREENSBORO
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State | NC
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Zip | 27410-2558
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Country | US
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Telephone | 919-391-0122
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Fax | 919-289-1758
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Authorized Official
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Title or Position | PRACTICE OWNER, THERAPIST
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Name | JESSICA LEISTIKOW
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Credential | LCMHC
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Telephone | 919-391-0122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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