Healthcare Provider Details

I. General information

NPI: 1871058909
Provider Name (Legal Business Name): ADAM JOSEPH MILLER WOJTECZKO LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2019
Last Update Date: 02/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 E EXPOSITION AVE STE 500
DENVER CO
80209-5033
US

IV. Provider business mailing address

3697 S DEPEW ST UNIT 9
LAKEWOOD CO
80235-2847
US

V. Phone/Fax

Practice location:
  • Phone: 720-306-1383
  • Fax:
Mailing address:
  • Phone: 303-335-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14796
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: