Provider Demographics
NPI:1184178527
Name:IM COUNSELING
Entity Type:Organization
Organization Name:IM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-939-2213
Mailing Address - Street 1:609 W LITTLETON BLVD
Mailing Address - Street 2:SUITE #309
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2368
Mailing Address - Country:US
Mailing Address - Phone:720-939-2213
Mailing Address - Fax:
Practice Address - Street 1:8850 BLUE MOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-2803
Practice Address - Country:US
Practice Address - Phone:720-939-2213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-14
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 0011476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty