Healthcare Provider Details
I. General information
NPI: 1134800550
Provider Name (Legal Business Name): MOMENTUM COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2023
Last Update Date: 08/06/2023
Certification Date: 08/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 E UNION AVE STE 1100
DENVER CO
80237-2746
US
IV. Provider business mailing address
2120 MILESTONE DR STE 103
FORT COLLINS CO
80525-5761
US
V. Phone/Fax
- Phone: 970-829-8780
- Fax: 970-341-2074
- Phone: 970-829-8780
- Fax: 970-341-2074
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAMOND
DOTSON
Title or Position: BILLING MANAGER
Credential: PHD, LMFT
Phone: 970-576-1717