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NPI Code Detail

MEDICARE: MOMENTUM COUNSELING AND CONSULTING LLC

MEDICARE: MOMENTUM COUNSELING AND CONSULTING 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
1251S00000XCommunity/Behavioral Health Agency
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1780356188
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOMENTUM COUNSELING AND CONSULTING LLC
Provider Business Mailing Address
First Line : 2120 MILESTONE DR.
Second Line : SUITE 103
City : FT. COLLINS
State : CO
Zip : 80525-5761
Country : US
Telephone Number : 970-829-8780
Fax Number :
Provider Business Practice Location Address
First Line : 2120 MILESTONE DR.
Second Line : SUITE 103
City : FT. COLLINS
State : CO
Zip : 80525-5761
Country : US
Telephone Number : 970-829-8780
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : MR. DAMOND R DOTSON
Credential : PHD LMFT
Telephone Number : 970-576-1717
Provider Enumeration Date : 10/04/2021
Last Update Date : 02/21/2024

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Directions to “MOMENTUM COUNSELING AND CONSULTING LLC ” Practice Location

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