Provider Demographics
NPI:1275240418
Name:QUIROGA, JOSUE MANUEL (LPCC)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:MANUEL
Last Name:QUIROGA
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 SILKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-6716
Mailing Address - Country:US
Mailing Address - Phone:830-279-5922
Mailing Address - Fax:
Practice Address - Street 1:2130 ACADEMY CIR STE E
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1661
Practice Address - Country:US
Practice Address - Phone:719-204-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health