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Organization
PUEBLO SENIOR COUNSELING LLC
Active
Organization
PUEBLO SENIOR COUNSELING LLC
Active
Other names
Colorado Springs Senior Counseling LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN SPENCER MSW, LICSW, LCSW (MENTAL HEALTH COUNSELOR)
(425) 903-1103
Entity
Organization
Contact information
Practice address
503 N MAIN ST STE 211, PUEBLO, CO 81003-3138
(425) 903-1103
Mailing address
1317 N VERMILLION CT, PUEBLO, CO 81007-1345
(425) 903-1103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6L3403
MEDICARE/COMMERCIAL INSURANCE
CO
01
—
6L3403
MEDICARE/COMMERCIAL INSURANCE
WA
05
—
6L3403
—
CO
Enumeration date
03/13/2024
Last updated
03/13/2024
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