My Quality Life Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFT.0001193 Issued in CO

Legal business name

MY QUALITY LIFE COUNSELING, LLC

Practice address

1864 Woodmoor Dr Ste 202
Monument, CO 80132-7464

Phone

(719) 695-0757

Fax

(719) 532-9576

NPI assigned

Aug 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lisa M. Runzo, LPC, LMFTNPI 1023362944

Title

Therapist and Owner

Phone

(719) 695-0757

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• My Quality Life Counseling, LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Runzo, MA, LPC, LMFT

  • Marriage & Family Therapist
  • Colorado Springs, CO
  • NPI 1023362944
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1104306547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 WOODMOOR DR STE 202",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801327464",
            "telephone_number": "719-695-0757",
            "fax_number": "719-532-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 WOODMOOR DR STE 202",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801327464",
            "telephone_number": "719-695-0757",
            "fax_number": "719-532-9576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 Lake Plaza Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809063581",
            "country_code": "US",
            "telephone_number": "719-695-0757",
            "fax_number": "719-532-9576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY QUALITY LIFE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "RUNZO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "THERAPIST AND OWNER",
        "authorized_official_telephone_number": "719-695-0757",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CO",
            "license": "MFT.0001193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000163731",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Quality Life Counseling, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Monument, CO
• Providers in Monument, CO by specialty
• Community/Behavioral Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.