Healthcare Provider Details

I. General information

NPI: 1750813697
Provider Name (Legal Business Name): NOS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 S JACKSON ST STE 704
DENVER CO
80210-3806
US

IV. Provider business mailing address

1776 S JACKSON ST STE 704
DENVER CO
80210-3806
US

V. Phone/Fax

Practice location:
  • Phone: 720-412-9648
  • Fax:
Mailing address:
  • Phone: 720-412-9648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberLPC.0012813
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberLPC.0012813
License Number StateCO

VIII. Authorized Official

Name: TAMARA BRUSKI
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential:
Phone: 720-971-6010