Healthcare Provider Details

I. General information

NPI: 1639614092
Provider Name (Legal Business Name): INTO THE WOODS COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7009 S. POTOMAC ST. SUITE 102
CENTENNIAL CO
80112-4034
US

IV. Provider business mailing address

1235 N. LOGAN ST. APT. 302
DENVER CO
80203-2464
US

V. Phone/Fax

Practice location:
  • Phone: 720-213-6180
  • Fax:
Mailing address:
  • Phone: 720-585-5110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0012993
License Number StateCO

VIII. Authorized Official

Name: KRISTIN KAYE SEARCEY
Title or Position: LPC/OWNER
Credential: LPC
Phone: 720-585-5110