Organization Name: | COLORADO PLAINS COUNSELING, LLC |
NPI Number: | 1467466714 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAKIRAH C HEMSTROM (OWNER/OPERATOR) |
Mailing Address: | 216 1st St Unit F Eaton |
State: | CO US |
Postal Code: | 806153477 |
Phone Number: | 9703024667 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2006 |
NPI Last Update Date: | 09/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |