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NPI Code Detail

MEDICARE: WILD JUNIPER COUNSELING, LLC

MEDICARE: WILD JUNIPER COUNSELING, 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366396640
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILD JUNIPER COUNSELING, LLC
Provider Business Mailing Address
First Line : 4672 BEELER CT APT 501
Second Line :
City : DENVER
State : CO
Zip : 80238-4467
Country : US
Telephone Number : 720-440-2962
Fax Number :
Provider Business Practice Location Address
First Line : 4672 BEELER CT APT 501
Second Line :
City : DENVER
State : CO
Zip : 80238-4467
Country : US
Telephone Number : 720-440-2962
Fax Number :
Authorized Official
Title or Position : LPC
Name : MELISSA MCCORMICK
Credential : LPC
Telephone Number : 720-440-2962
Provider Enumeration Date : 02/24/2026
Last Update Date : 02/24/2026

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Directions to “WILD JUNIPER COUNSELING, LLC ” Practice Location

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