Provider Demographics
NPI:1164153391
Name:OASIS SPRINGS CHILDREN'S COUNSELING CENTER
Entity Type:Organization
Organization Name:OASIS SPRINGS CHILDREN'S COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUTAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:817-296-4552
Mailing Address - Street 1:2790 N ACADEMY BLVD STE 347
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5328
Mailing Address - Country:US
Mailing Address - Phone:719-407-2093
Mailing Address - Fax:
Practice Address - Street 1:2790 N ACADEMY BLVD STE 347
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5328
Practice Address - Country:US
Practice Address - Phone:719-407-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty