Provider Demographics
NPI:1629468285
Name:PURE SPRING FAMILY COUNSELING CENTER
Entity Type:Organization
Organization Name:PURE SPRING FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-842-5781
Mailing Address - Street 1:PO BOX 1714
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-1714
Mailing Address - Country:US
Mailing Address - Phone:303-842-5781
Mailing Address - Fax:303-464-9384
Practice Address - Street 1:7050 W 120TH AVE UNIT 200B
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7604
Practice Address - Country:US
Practice Address - Phone:303-842-5781
Practice Address - Fax:303-464-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty