Provider Demographics
NPI:1376242263
Name:RED MOUNTAIN COUNSELING, LLC
Entity Type:Organization
Organization Name:RED MOUNTAIN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-610-5352
Mailing Address - Street 1:6520 DELMONICO DR APT 108
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-6804
Mailing Address - Country:US
Mailing Address - Phone:704-610-5352
Mailing Address - Fax:
Practice Address - Street 1:6180 LEHMAN DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3415
Practice Address - Country:US
Practice Address - Phone:704-610-5352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty