1306178017 NPI number — ART OF REDIRECTION COUNSELING INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306178017 NPI number — ART OF REDIRECTION COUNSELING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ART OF REDIRECTION COUNSELING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306178017
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4360 MONTEBELLO DR
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80918-7204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-593-9228
Provider Business Mailing Address Fax Number:
719-578-1705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4360 MONTEBELLO DR
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80918-7204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-593-9228
Provider Business Practice Location Address Fax Number:
719-578-1705
Provider Enumeration Date:
02/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
WENZEL
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
BRUCE
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
719-593-9228

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  3204 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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