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General NPI Number Information
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NPI Number | 1396176632
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Entity Type | Organization
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Legal Business Name | K.I.D.S. & FAMILY COUNSELING SERVICES
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 24761 HILLSIDE RD
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City | PUEBLO
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State | CO
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Zip | 81006-3023
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Country | US
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Telephone | 719-334-6178
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Fax |
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Provider Business Mailing Address
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Address Line | 24761 HILLSIDE RD
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City | PUEBLO
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State | CO
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Zip | 81006-3023
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Country | US
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Telephone | 719-334-6178
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | LINDA M LITZENBERGER
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Credential |
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Telephone | 719-334-6178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0006261
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License Number State | CO
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