Organization
INGRID VAN HAITSMA COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID VAN HAITSMA LCSW, LAC (THERAPIST/OWNER)
(616) 915-8203
Entity
Organization
Contact information
Practice address
500 COFFMAN ST STE 204, LONGMONT, CO 80501-5445
(720) 893-1683
Mailing address
44 POWDER HORN PL # 204, LONGMONT, CO 80504-1233
(616) 915-8203
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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