Provider Demographics
NPI:1063851558
Name:RESTORATION COUNSELING
Entity Type:Organization
Organization Name:RESTORATION COUNSELING
Other - Org Name:RESTORATION COUNSELING CENTER OF NORTHERN COLORADO
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/DIRECTOR/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MACP, MA
Authorized Official - Phone:970-213-9468
Mailing Address - Street 1:PO BOX 273112
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80527-3112
Mailing Address - Country:US
Mailing Address - Phone:970-213-9468
Mailing Address - Fax:
Practice Address - Street 1:605 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3003
Practice Address - Country:US
Practice Address - Phone:970-213-9468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty