# HEARTSPACE KIDS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heartspace Kids Counseling Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669181889
- **Authorized official:** DINA MARK LPC (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (719) 358-7437

## Contact information

- **Practice address:** 1235 LAKE PLAZA DR STE 230, COLORADO SPRINGS, CO 80906-3556
- **Practice address phone:** (719) 358-7437
- **Mailing address:** 1235 LAKE PLAZA DR STE 230, COLORADO SPRINGS, CO 80906-3556
- **Mailing address phone:** (719) 358-7437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2022
- **Last updated:** 11/16/2022