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Organization
ROCKY TRAILS COUNSELING PLLC
Active
Organization
ROCKY TRAILS COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY JOHNSON MA, LPC, LAC (PRIVATE PRACTICE OWNER)
(719) 345-7095
Entity
Organization
Contact information
Practice address
801 N WEBER ST STE 103, COLORADO SPRINGS, CO 80903-5927
(719) 345-7095
Mailing address
2057 BROOKWOOD DR, COLORADO SPRINGS, CO 80918-1135
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000203832
—
CO
Enumeration date
07/14/2022
Last updated
07/14/2022
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