MEDICARE: CRESCITA COUNSELING LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1578311601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCITA COUNSELING LLC

Provider Business Mailing Address
First Line	:	627 N WEBER ST STE 6
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-5008
Country	:	US
Telephone Number	:	909-816-4107
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 N WEBER ST STE 6
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-5008
Country	:	US
Telephone Number	:	909-816-4107
Fax Number	:

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	KATIE FORTUNATO
Credential	:	LPC
Telephone Number	:	909-816-4107

Provider Enumeration Date	:	05/13/2024
Last Update Date	:	03/05/2026

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