MEDICARE: ASSENT BEHAVIORAL HEALTH

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1838-00	CO

General Provider Information

NPI Number	:	1932624251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSENT BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	3610 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-284-2780
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 S GALAPAGO ST
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-3421
Country	:	US
Telephone Number	:	303-284-2780
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MS. KAMMY BISHOP
Credential	:	LPC
Telephone Number	:	303-284-2780

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	07/21/2022

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Directions to “ASSENT BEHAVIORAL HEALTH ” Practice Location

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