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Organization

PHASE TWO COUNSELING SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARGIE R. JONES-DUDLEY MA CCBT, CAC III (OWNER/DRIECTOR)
(719) 473-1805
Entity
Organization

Contact information

Practice address
2019 E BIJOU ST, SUITE #1, COLORADO SPRINGS, CO 80909-5818
(719) 473-1805
(719) 302-5324
Mailing address
2019 E BIJOU ST, SUITE #1, COLORADO SPRINGS, CO 80909-5818
(719) 473-1805
(719) 302-5324

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6148

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141948
CO
Enumeration date
05/16/2012
Last updated
05/16/2012
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