Provider Demographics
NPI:1013762210
Name:BESTOWED FORTITUDE COUNSELING SERVICES
Entity Type:Organization
Organization Name:BESTOWED FORTITUDE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:719-726-5530
Mailing Address - Street 1:11605 MERIDIAN MARKET VW
Mailing Address - Street 2:PMB138
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831
Mailing Address - Country:US
Mailing Address - Phone:719-726-5530
Mailing Address - Fax:
Practice Address - Street 1:10915 BLACK FOREST RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-3935
Practice Address - Country:US
Practice Address - Phone:719-726-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health