Provider Demographics
NPI:1275024044
Name:ROCK YOUR FAMILY, LLC
Entity Type:Organization
Organization Name:ROCK YOUR FAMILY, LLC
Other - Org Name:ROCK YOUR FAMILY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-362-0796
Mailing Address - Street 1:1465 KELLY JOHNSON BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3947
Mailing Address - Country:US
Mailing Address - Phone:719-235-2495
Mailing Address - Fax:719-375-3004
Practice Address - Street 1:1465 KELLY JOHNSON BLVD STE 305
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3947
Practice Address - Country:US
Practice Address - Phone:719-362-0796
Practice Address - Fax:719-375-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-28
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014064101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12179498Medicaid
COLPC.0014064OtherCOUNSELOR