Provider Demographics
NPI:1467995787
Name:JOSLYN, ROBERT (MA, LAC, LPCC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:JOSLYN
Suffix:
Gender:M
Credentials:MA, LAC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 LA MONTANA WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6700
Mailing Address - Country:US
Mailing Address - Phone:719-528-3500
Mailing Address - Fax:719-528-2433
Practice Address - Street 1:5390 N ACADEMY BLVD STE 330
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4176
Practice Address - Country:US
Practice Address - Phone:719-466-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000632101YA0400X
CO14603101YP2500X
COLPCC.0014685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health