Provider Demographics
NPI:1871062109
Name:SOJOURN COUNSELING CENTER
Entity type:Organization
Organization Name:SOJOURN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UZRI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:719-331-5989
Mailing Address - Street 1:430 BEACON LITE RD UNIT 140
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9146
Mailing Address - Country:US
Mailing Address - Phone:719-331-5989
Mailing Address - Fax:719-309-0081
Practice Address - Street 1:430 BEACON LITE RD UNIT 140
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9146
Practice Address - Country:US
Practice Address - Phone:719-331-5989
Practice Address - Fax:719-309-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty