Provider Demographics
NPI:1447915129
Name:FOOTPRINTS OF CHANGE COUNSELING PLLC
Entity type:Organization
Organization Name:FOOTPRINTS OF CHANGE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE-ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABENROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-749-6211
Mailing Address - Street 1:355 N ELLICOTT HWY # A101
Mailing Address - Street 2:
Mailing Address - City:CALHAN
Mailing Address - State:CO
Mailing Address - Zip Code:80808-8877
Mailing Address - Country:US
Mailing Address - Phone:719-749-6211
Mailing Address - Fax:719-500-4465
Practice Address - Street 1:355 N ELLICOTT HWY # A101
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-8877
Practice Address - Country:US
Practice Address - Phone:719-749-6211
Practice Address - Fax:719-500-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty