MEDICARE: WHOLE CONNECTION LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist
3	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1467163790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE CONNECTION LLC

Provider Business Mailing Address
First Line	:	5335 W 48TH AVE FL 5
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5335 W 48TH AVE FL 5
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2731
Country	:	US
Telephone Number	:	720-442-0946
Fax Number	:	720-590-6618

Authorized Official
Title or Position	:	OPERATING DIRECTOR
Name	:	PHILLIP HORNER
Credential	:
Telephone Number	:	720-316-7774

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	12/21/2022

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Directions to “WHOLE CONNECTION LLC ” Practice Location

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