Healthcare Provider Details

I. General information

NPI: 1700436409
Provider Name (Legal Business Name): LA PLATA FAMILY COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E 8TH AVE STE 206
DURANGO CO
81301-5708
US

IV. Provider business mailing address

204 PROSPECTOR AVE
DURANGO CO
81301-7953
US

V. Phone/Fax

Practice location:
  • Phone: 970-769-0131
  • Fax:
Mailing address:
  • Phone: 970-769-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HILLARY WOLFE
Title or Position: OWNER
Credential: LCSW
Phone: 970-769-0131