Provider Demographics
NPI:1578918868
Name:REAL CONNECTIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:REAL CONNECTIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELGERSMA
Authorized Official - Suffix:
Authorized Official - Credentials:MLITT, MA, MFTC
Authorized Official - Phone:719-419-7633
Mailing Address - Street 1:5555 ERINDALE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6736
Mailing Address - Country:US
Mailing Address - Phone:719-419-7633
Mailing Address - Fax:
Practice Address - Street 1:5555 ERINDALE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6736
Practice Address - Country:US
Practice Address - Phone:719-419-7633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20131134448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty