Provider Demographics
NPI:1285186569
Name:BABCOCK COUNSELING, LLC
Entity Type:Organization
Organization Name:BABCOCK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BABCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-247-1350
Mailing Address - Street 1:PO BOX 77171
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80970-7171
Mailing Address - Country:US
Mailing Address - Phone:719-247-1350
Mailing Address - Fax:866-228-1268
Practice Address - Street 1:2502 W COLORADO AVE STE 201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3068
Practice Address - Country:US
Practice Address - Phone:719-247-1350
Practice Address - Fax:866-228-1268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012310101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty