Provider Demographics
NPI:1891112587
Name:ALPINE AWARENESS COUNSELING SERVICE
Entity Type:Organization
Organization Name:ALPINE AWARENESS COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENETTA
Authorized Official - Last Name:DUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-237-0409
Mailing Address - Street 1:5265 N ACADEMY BLVD STE 3300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4082
Mailing Address - Country:US
Mailing Address - Phone:719-466-6771
Mailing Address - Fax:
Practice Address - Street 1:5265 N ACADEMY BLVD STE 3300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4082
Practice Address - Country:US
Practice Address - Phone:719-466-6771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6512305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization