Provider Demographics
NPI:1447039284
Name:REFRESH COUNSELING AND SUPPORT SERVICES INC.
Entity type:Organization
Organization Name:REFRESH COUNSELING AND SUPPORT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CREDENTIALING MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:970-576-1717
Mailing Address - Street 1:1751 HOVER ST # B4-201
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7181
Mailing Address - Country:US
Mailing Address - Phone:720-534-5983
Mailing Address - Fax:720-222-5832
Practice Address - Street 1:923 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4512
Practice Address - Country:US
Practice Address - Phone:720-534-5983
Practice Address - Fax:720-222-5832
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REFRESH COUNSELING AND SUPPORT SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty