Provider Demographics
NPI:1578311601
Name:CRESCITA COUNSELING LLC
Entity type:Organization
Organization Name:CRESCITA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASQUALETTO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:909-816-4107
Mailing Address - Street 1:402 E SAN RAFAEL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2464
Mailing Address - Country:US
Mailing Address - Phone:909-816-4107
Mailing Address - Fax:
Practice Address - Street 1:402 E SAN RAFAEL ST APT 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2464
Practice Address - Country:US
Practice Address - Phone:909-816-4107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty