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General NPI Number Information
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NPI Number | 1942699335
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Entity Type | Organization
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Legal Business Name | RUNNING STREAM COUNSELING SERVICE, PC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 421 N MAIN ST
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City | PUEBLO
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State | CO
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Zip | 81003-3196
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Country | US
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Telephone | 719-214-3033
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Fax | 719-544-1186
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Provider Business Mailing Address
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Address Line | 18425 PONY EXPRESS DR SUITE 203
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City | PARKER
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State | CO
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Zip | 80134-9605
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Country | US
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Telephone | 303-805-1218
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Fax | 303-805-3679
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHARON GRIFFIN
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Credential | MPA
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Telephone | 303-805-1218
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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 | ACC.0001544
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License Number State | CO
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