Provider Demographics
NPI:1366134629
Name:PERALTA, JOVIE (MSW)
Entity type:Individual
Prefix:
First Name:JOVIE
Middle Name:
Last Name:PERALTA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:PERALTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7560 RANGEWOOD DR STE 130
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2100
Mailing Address - Country:US
Mailing Address - Phone:719-445-6499
Mailing Address - Fax:
Practice Address - Street 1:7560 RANGEWOOD DR STE 130
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2100
Practice Address - Country:US
Practice Address - Phone:719-445-6499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099257241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical