Provider Demographics
NPI:1457080202
Name:QUIET SPIRIT COUNSELING PROFESSIONAL LLC
Entity Type:Organization
Organization Name:QUIET SPIRIT COUNSELING PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:MONDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-201-7397
Mailing Address - Street 1:2371 MORNINGVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-3708
Mailing Address - Country:US
Mailing Address - Phone:719-201-7397
Mailing Address - Fax:
Practice Address - Street 1:4975 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5043
Practice Address - Country:US
Practice Address - Phone:719-201-7397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09925256OtherDORA