Provider Demographics
NPI:1699096107
Name:HINDS' FEET ADVENTURES
Entity type:Organization
Organization Name:HINDS' FEET ADVENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CACIII
Authorized Official - Phone:719-428-5432
Mailing Address - Street 1:1322 N ACADEMY BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3316
Mailing Address - Country:US
Mailing Address - Phone:719-428-5432
Mailing Address - Fax:719-428-5381
Practice Address - Street 1:1322 N ACADEMY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3316
Practice Address - Country:US
Practice Address - Phone:719-428-5432
Practice Address - Fax:719-428-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6223101YA0400X
101YA0400X
CO4584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty