Provider Demographics
NPI:1902561897
Name:ALDOVINA COUNSELING SERVICES
Entity Type:Organization
Organization Name:ALDOVINA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAMBONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-598-8560
Mailing Address - Street 1:2790 N ACADEMY BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5347
Mailing Address - Country:US
Mailing Address - Phone:719-598-8560
Mailing Address - Fax:719-426-2969
Practice Address - Street 1:2790 N ACADEMY BLVD STE 312
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5347
Practice Address - Country:US
Practice Address - Phone:719-598-8560
Practice Address - Fax:719-426-2969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000197591Medicaid