Healthcare Provider Details

I. General information

NPI: 1235672031
Provider Name (Legal Business Name): JULIE REICHENBERGER, MA, LPC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 SOUTH BELLAIRE STREET, SUITE 485
DENVER CO
80222
US

IV. Provider business mailing address

1780 S BELLAIRE ST STE 485
DENVER CO
80222-4326
US

V. Phone/Fax

Practice location:
  • Phone: 303-809-3341
  • Fax:
Mailing address:
  • Phone: 303-809-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC11098
License Number StateCO

VIII. Authorized Official

Name: JULIE REICHENBERGER
Title or Position: OWNER
Credential:
Phone: 312-720-7965