Provider Demographics
NPI:1578920690
Name:ALL LIFE LONG COUNSELING AND CONSULTING, PLLC.
Entity Type:Organization
Organization Name:ALL LIFE LONG COUNSELING AND CONSULTING, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:BECKY
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-331-7445
Mailing Address - Street 1:2316 N WAHSATCH AVE
Mailing Address - Street 2:SUITE # 240
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6968
Mailing Address - Country:US
Mailing Address - Phone:719-331-7445
Mailing Address - Fax:719-375-3915
Practice Address - Street 1:1426 N HANCOCK AVE
Practice Address - Street 2:SUITE 5N
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2618
Practice Address - Country:US
Practice Address - Phone:719-331-7445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty