Healthcare Provider Details

I. General information

NPI: 1760999684
Provider Name (Legal Business Name): FOUNDATIONS FAMILY COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2017
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 N SHERMAN ST STE 440
DENVER CO
80203-3531
US

IV. Provider business mailing address

789 N SHERMAN ST STE 440
DENVER CO
80203-3531
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-0085
  • Fax: 720-221-9287
Mailing address:
  • Phone: 303-393-0085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY SUNDQUIST JOSE
Title or Position: OWNER
Credential: MA LPC RPT-S
Phone: 303-393-0085