Healthcare Provider Details

I. General information

NPI: 1265278360
Provider Name (Legal Business Name): AMOS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W 2ND ST
DELTA CO
81416-1801
US

IV. Provider business mailing address

1131 N 21ST ST
GRAND JUNCTION CO
81501-6576
US

V. Phone/Fax

Practice location:
  • Phone: 970-399-3133
  • Fax:
Mailing address:
  • Phone: 970-778-4360
  • Fax: 970-241-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARTHA AMOS
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PH. D, LPC, LAC
Phone: 970-778-4360