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General NPI Number Information
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NPI Number | 1922371434
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Entity Type | Organization
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Legal Business Name | ALCHEMY OF HEALING COUNSELING, LLC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 09/15/2014
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Provider Practice Location Address
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Address Line | 2163 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1507
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Country | US
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Telephone | 303-217-3732
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Fax |
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Provider Business Mailing Address
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Address Line | 2163 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1507
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Country | US
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Telephone | 303-217-3732
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | BITA ASHOURI RIVAS
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Credential | ED.D, LPC, NCC
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Telephone | 303-217-3732
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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 | 11962
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 13493
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11962
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13493
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11962
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License Number State | CO
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11298
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License Number State | CO
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