Provider Demographics
NPI:1689946477
Name:SOUTH PLATTE COMMUNITY COUNSELING
Entity Type:Organization
Organization Name:SOUTH PLATTE COMMUNITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, CACIII
Authorized Official - Phone:970-522-0612
Mailing Address - Street 1:PO BOX 827
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-0827
Mailing Address - Country:US
Mailing Address - Phone:970-522-0612
Mailing Address - Fax:970-522-0746
Practice Address - Street 1:208 N 3RD ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4302
Practice Address - Country:US
Practice Address - Phone:970-522-0612
Practice Address - Fax:970-522-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6522251S00000X
CO4648251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health