Healthcare Provider Details

I. General information

NPI: 1922393073
Provider Name (Legal Business Name): COLORADO AUTISM CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10650 E BETHANY DR
AURORA CO
80014-2653
US

IV. Provider business mailing address

PO BOX 4804
BUENA VISTA CO
81211-4804
US

V. Phone/Fax

Practice location:
  • Phone: 800-536-2340
  • Fax: 303-957-2251
Mailing address:
  • Phone: 970-433-8339
  • Fax: 303-957-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0093572
License Number StateCO

VIII. Authorized Official

Name: MRS. ABIGAIL KOENIG
Title or Position: OWNER/BEHAVIORAL CONSULTANT
Credential: BCBA
Phone: 970-433-8339