Provider Demographics
NPI:1598231656
Name:RENEE PODUNOVICH COUNSELING SERVICES
Entity Type:Organization
Organization Name:RENEE PODUNOVICH COUNSELING SERVICES
Other - Org Name:MIND BODY CONNECTIONS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PODUNOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:385-232-3671
Mailing Address - Street 1:202 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-3121
Mailing Address - Country:US
Mailing Address - Phone:385-232-3671
Mailing Address - Fax:801-384-0610
Practice Address - Street 1:202 W NORTH ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3121
Practice Address - Country:US
Practice Address - Phone:385-232-3671
Practice Address - Fax:801-384-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty