Healthcare Provider Details

I. General information

NPI: 1851681555
Provider Name (Legal Business Name): COUNSELING CENTER OF THE ROCKIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4195 S BROADWAY
ENGLEWOOD CO
80113-4794
US

IV. Provider business mailing address

3489 W 72ND AVE STE 104
WESTMINSTER CO
80030-5314
US

V. Phone/Fax

Practice location:
  • Phone: 303-806-0933
  • Fax: 303-382-3959
Mailing address:
  • Phone: 303-806-0933
  • Fax: 303-806-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1352-01
License Number StateCO

VIII. Authorized Official

Name: JENNIFER C HODGE
Title or Position: CLINICAL DIRECTOR
Credential: CACIII
Phone: 303-806-0933