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General NPI Number Information
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NPI Number | 1477080430
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Entity Type | Organization
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Legal Business Name | MOUNTAINEER COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 05/20/2017
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 7855 PINE CONE RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-6117
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Country | US
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Telephone | 719-338-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 7855 PINE CONE RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-6117
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Country | US
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Telephone | 719-338-4665
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Fax | 719-548-8396
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID C. SOLLY
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Credential | EDD
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Telephone | 719-338-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2835
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License Number State | CO
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