MEDICARE: MINDFUL SPRINGS COUNSELING AND WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164235032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL SPRINGS COUNSELING AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	1618 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4029
Country	:	US
Telephone Number	:	719-357-8957
Fax Number	:	719-452-3580

Provider Business Practice Location Address
First Line	:	1618 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4029
Country	:	US
Telephone Number	:	719-357-8957
Fax Number	:	719-452-3580

Authorized Official
Title or Position	:	OWNER
Name	:	AIMEE SOLIS
Credential	:	LCPC
Telephone Number	:	708-204-3555

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/31/2025

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