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General NPI Number Information
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NPI Number | 1578920690
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Entity Type | Organization
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Legal Business Name | ALL LIFE LONG COUNSELING AND CONSULTING, PLLC.
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 1426 N HANCOCK AVE SUITE 5N
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2618
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Country | US
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Telephone | 719-331-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 2316 N WAHSATCH AVE SUITE # 240
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6968
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Country | US
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Telephone | 719-331-7445
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Fax | 719-375-3915
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DARLENE BECKY AVERY
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Credential | LCSW
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Telephone | 719-331-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1842
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License Number State | CO
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