| My Quality Life Counseling, Llc | |
|
1864 Woodmoor Dr Ste 202 Monument CO 80132-7464 | |
| (719) 695-0757 | |
| (719) 532-9576 |
| Full Name | My Quality Life Counseling, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1864 Woodmoor Dr Ste 202, Monument, Colorado |
| Authorized Official Name and Position | Lisa M. Runzo (THERAPIST AND OWNER) |
| Authorized Official Contact | 7196950757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Quality Life Counseling, Llc 1864 Woodmoor Dr Ste 202 Monument CO 80132-7464 Ph: (719) 695-0757 | My Quality Life Counseling, Llc 1864 Woodmoor Dr Ste 202 Monument CO 80132-7464 Ph: (719) 695-0757 |
| NPI Number | 1104306547 |
|---|---|
| Provider Enumeration Date | 08/15/2018 |
| Last Update Date | 08/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104306547 | NPI | - | NPPES |
| 9000163731 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MFT.0001193 (Colorado) | Primary |
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