Organization
COUNSELING SERVICES OF LONGMONT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY DE HERRERA (OWNER)
(303) 772-3853
Entity
Organization
Contact information
Practice address
1129 FRANCIS ST, LONGMONT, CO 80501-3703
(303) 772-3853
(303) 772-1718
Mailing address
1129 FRANCIS ST, LONGMONT, CO 80501-3703
(303) 772-3853
(303) 772-1718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
178800
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598112112
—
CO
05
—
1710104112
—
CO
Enumeration date
05/31/2016
Last updated
05/31/2016
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