MEDICARE: NORTHERN COLORADO MENTAL HEALTH ASSOCIATES, PROF LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265965560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN COLORADO MENTAL HEALTH ASSOCIATES, PROF LLC

Provider Business Mailing Address
First Line	:	343 W DRAKE RD
Second Line	:	SUITE 200
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-218-7369
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 W DRAKE RD
Second Line	:	SUITE 200
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	970-218-7369
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. AARON MENG
Credential	:	MD
Telephone Number	:	970-218-7369

Provider Enumeration Date	:	04/04/2017
Last Update Date	:	04/04/2017

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