Provider Demographics
NPI:1750059929
Name:LUTHERAN SOCIAL SERVICES OF COLORADO
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF COLORADO
Other - Org Name:LUTHERAN FAMILY SERVICES ROCKY MOUNTAINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-988-4634
Mailing Address - Street 1:1035 OSAGE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4209
Mailing Address - Country:US
Mailing Address - Phone:303-922-3433
Mailing Address - Fax:
Practice Address - Street 1:108 E SAINT VRAIN ST STE 21
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1161
Practice Address - Country:US
Practice Address - Phone:719-227-7571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SOCIAL SERVICES OF COLORADO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-02
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251V00000XAgenciesVoluntary or Charitable
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty