MEDICARE: COLORADO MOTION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103TC1900X	Counseling Psychologist
3	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1578230405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO MOTION

Provider Business Mailing Address
First Line	:	9475 BRIAR VILLAGE PT STE 325
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7907
Country	:	US
Telephone Number	:	719-432-9222
Fax Number	:	719-960-2894

Provider Business Practice Location Address
First Line	:	9475 BRIAR VILLAGE PT STE 325
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7907
Country	:	US
Telephone Number	:	719-432-9222
Fax Number	:	719-960-2894

Authorized Official
Title or Position	:	OWNER AND FOUNDER
Name	:	JEREMY ROGERS
Credential	:	LPC
Telephone Number	:	719-432-9222

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	08/27/2021

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Directions to “COLORADO MOTION ” Practice Location

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