MEDICARE: OPEN HANDS COUNSELING GROUP

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1548979826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN HANDS COUNSELING GROUP

Provider Business Mailing Address
First Line	:	324 E RAILROAD AVE STE 500
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3144
Country	:	US
Telephone Number	:	970-458-5124
Fax Number	:	970-205-9604

Provider Business Practice Location Address
First Line	:	324 E RAILROAD AVE STE 500
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3144
Country	:	US
Telephone Number	:	970-458-5124
Fax Number	:	970-205-9604

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CECILE KATHERINE MARQUEZ
Credential	:	MA, LPC
Telephone Number	:	970-458-5124

Provider Enumeration Date	:	11/16/2022
Last Update Date	:	11/16/2022

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