Healthcare Provider Details

I. General information

NPI: 1649023383
Provider Name (Legal Business Name): BRETT ASTOR COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 NORTH ST
BOULDER CO
80304-3419
US

IV. Provider business mailing address

901 ROSEWOOD AVE
BOULDER CO
80304-0833
US

V. Phone/Fax

Practice location:
  • Phone: 720-334-7744
  • Fax:
Mailing address:
  • Phone: 207-749-9489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRETT ASTOR
Title or Position: OWNER
Credential: LPC
Phone: 720-334-7744