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General NPI Number Information
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NPI Number | 1952174286
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Entity Type | Organization
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Legal Business Name | SONG SPARROW COUNSELING LLC
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 287 CENTURY CIR STE 100
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City | LOUISVILLE
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State | CO
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Zip | 80027-1684
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Country | US
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Telephone | 720-310-8241
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Fax |
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Provider Business Mailing Address
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Address Line | 287 CENTURY CIR STE 100
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City | LOUISVILLE
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State | CO
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Zip | 80027-1684
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Country | US
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Telephone | 720-310-8241
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Fax |
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Authorized Official
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Title or Position | THERAPIST OWNER
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Name | CHARLES ROSICKY
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Credential | LSCW
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Telephone | 720-310-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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