Colorado College Counseling Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1569 Issued in CO

Legal business name

COLORADO COLLEGE COUNSELING CENTER

Practice address

1106 N Cascade Ave
Colorado Springs, CO 80903-1355

Phone

(719) 389-6384

Fax

(719) 389-6928

NPI assigned

Apr 16, 2009

Last updated

Apr 16, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

THE COLORADO COLLEGEAs reported in NPPES

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

Authorized official

Name

Dr. William Dove, PH.D.

Title

Counseling Supervisor

Phone

(719) 389-6384

Specialties & licenses 7

Addresses

Tax ID family

Colorado College Counseling Center2 organizations share this tax ID, including this one

Part of

Colorado College Counseling Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Colorado College Boettcher Health Center

  • Student Health Clinic/Center
  • Colorado Springs, CO
  • NPI 1295862480
  NPD tax ID

Locations

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1700029030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N CASCADE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031355",
            "telephone_number": "719-389-6384",
            "fax_number": "719-389-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N CASCADE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031355",
            "telephone_number": "719-389-6384",
            "fax_number": "719-389-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO COLLEGE COUNSELING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE COLORADO COLLEGE",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "DOVE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "COUNSELING SUPERVISOR",
        "authorized_official_telephone_number": "719-389-6384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "2589",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "422",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2810",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "1569",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989086",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989775",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "27976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.