Organization
PPSOC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN EVANS MFTC (OWNER/MEMBER MANAGER)
(719) 510-7056
Entity
Organization
Contact information
Practice address
3204 N ACADEMY BLVD STE 200, COLORADO SPRINGS, CO 80917-5163
(888) 211-8537
(614) 656-6614
Mailing address
PO BOX 351, CONVOY, OH 45832-0351
(719) 510-7056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
103TH0004X
Health Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/13/2022
Last updated
08/02/2022
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