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General NPI Number Information
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NPI Number | 1528498599
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Entity Type | Organization
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Legal Business Name | COUNSELING PARTNERS, LLC
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 2860 S CIRCLE DR SUITE #115
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4113
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Country | US
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Telephone | 719-634-1240
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Fax | 719-540-0174
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Provider Business Mailing Address
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Address Line | 2860 S CIRCLE DR SUITE #115
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4113
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Country | US
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Telephone | 719-634-1240
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Fax | 719-540-0174
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. IDA 'JOYCE' RANDALL
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Credential | MA, CFI
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Telephone | 719-634-1240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1745-01
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License Number State | CO
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