Organization
ALPINE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY L NICHOLS LCSW (CO-OWNER)
(719) 595-0020
Entity
Organization
Contact information
Practice address
2502 COURT ST, PUEBLO, CO 81003-2430
(719) 595-0020
(719) 542-1634
Mailing address
2502 COURT ST, PUEBLO, CO 81003-2430
(719) 595-0020
(719) 542-1634
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034147
—
CO
05
—
035268
—
CO
Enumeration date
06/23/2006
Last updated
12/14/2011
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