Provider Demographics
NPI:1710711478
Name:ALPINE CREEK COUNSELING LLC
Entity type:Organization
Organization Name:ALPINE CREEK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GEARS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-480-5021
Mailing Address - Street 1:421 PONCHA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2130
Mailing Address - Country:US
Mailing Address - Phone:719-480-5021
Mailing Address - Fax:
Practice Address - Street 1:315 STATE AVE # 203
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2637
Practice Address - Country:US
Practice Address - Phone:719-480-8735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty