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Organization
HEARTSPACE KIDS INC
Active
Organization
HEARTSPACE KIDS INC
Active
Other names
Heartspace Kids Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DINA MARK LPC (EXECUTIVE DIRECTOR)
(719) 358-7437
Entity
Organization
Contact information
Practice address
1235 LAKE PLAZA DR STE 230, COLORADO SPRINGS, CO 80906-3556
(719) 358-7437
Mailing address
1235 LAKE PLAZA DR STE 230, COLORADO SPRINGS, CO 80906-3556
(719) 358-7437
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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