Provider Demographics
NPI:1891482469
Name:HOLLEN, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HOLLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 N. PROSPECT ST.
Mailing Address - Street 2:COLORADO SPRINGS 80907
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907
Mailing Address - Country:US
Mailing Address - Phone:406-314-7345
Mailing Address - Fax:
Practice Address - Street 1:1416 N. PROSPECT ST.
Practice Address - Street 2:COLORADO SPRINGS 80907
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:406-314-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW09926517101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health