Healthcare Provider Details

I. General information

NPI: 1104638956
Provider Name (Legal Business Name): TALL TREE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 04/13/2025
Certification Date: 04/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 S BELLAIRE ST STE 400
DENVER CO
80222-4321
US

IV. Provider business mailing address

PO BOX 16202
DENVER CO
80216-0202
US

V. Phone/Fax

Practice location:
  • Phone: 303-829-5413
  • Fax:
Mailing address:
  • Phone: 303-829-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TONYA R EWERS
Title or Position: PRINCIPAL COUNSELOR & OWNER
Credential: LPC
Phone: 303-829-5413