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Organization
ROM 12-2 COUNSELING
Active
Organization
ROM 12-2 COUNSELING
Active
Parent organization
ROM 12-2 COUNSELING
Other names
Mind Renewal Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROM 12-2 COUNSELING
Authorized official
MR. CARLOS VILLAFAN LPC (OWNER)
(719) 465-2582
Entity
Organization
Contact information
Practice address
660 SOUTHPOINTE CT STE 200, COLORADO SPRINGS, CO 80906-3874
(719) 465-2582
(719) 465-2643
Mailing address
660 SOUTHPOINTE CT STE 200, COLORADO SPRINGS, CO 80906-3874
(719) 465-2582
(719) 465-2643
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5586
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174713325
INDIVIDUAL NPI
CO
05
—
671490
—
CO
Enumeration date
05/19/2017
Last updated
02/26/2024
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