Healthcare Provider Details

I. General information

NPI: 1275044117
Provider Name (Legal Business Name): ASCENT MUSIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 OHIO WAY
DENVER CO
80209-4829
US

IV. Provider business mailing address

2919 OHIO WAY
DENVER CO
80209-4829
US

V. Phone/Fax

Practice location:
  • Phone: 630-440-5232
  • Fax:
Mailing address:
  • Phone: 630-440-5232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW J LODOLCE
Title or Position: OWNER/FOUNDER
Credential:
Phone: 630-440-5232