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Organization
FRESH WATER COUNSELING, LLC
Active
Organization
FRESH WATER COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FAVARA LPC (OWNER)
(303) 895-7874
Entity
Organization
Contact information
Practice address
3230 E WOODMEN RD STE 110A, COLORADO SPRINGS, CO 80920-8502
(719) 301-9532
Mailing address
5390 BALSAM ST, COLO SPGS, CO 80923-5104
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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