Provider Demographics
NPI:1922240076
Name:THE HEALING PLACE COUNSELING CENTER
Entity Type:Organization
Organization Name:THE HEALING PLACE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REO
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMFT, LPC, CACIII
Authorized Official - Phone:720-859-0464
Mailing Address - Street 1:12101 E 2ND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8327
Mailing Address - Country:US
Mailing Address - Phone:720-859-0464
Mailing Address - Fax:720-859-2970
Practice Address - Street 1:12101 E 2ND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8327
Practice Address - Country:US
Practice Address - Phone:720-859-0464
Practice Address - Fax:720-859-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20041450283251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health