Healthcare Provider Details
I. General information
NPI: 1760783815
Provider Name (Legal Business Name): PATHFINDERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2010
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
312 ASPEN AIRPORT BUSINESS CTR STE B
ASPEN CO
81611-2568
US
IV. Provider business mailing address
PO BOX 11799
ASPEN CO
81612-9450
US
V. Phone/Fax
- Phone: 970-925-1226
- Fax: 970-544-3867
- Phone: 970-925-1226
- Fax: 970-544-3867
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1017 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 4736 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 4736 |
| License Number State | CO |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
ELIZABETH
MEANS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 970-925-1226