Healthcare Provider Details

I. General information

NPI: 1134841786
Provider Name (Legal Business Name): ASU COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 07/25/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14621 COUNTY ROAD 18
FORT MORGAN CO
80701-8413
US

IV. Provider business mailing address

14621 COUNTY ROAD 18
FORT MORGAN CO
80701-8413
US

V. Phone/Fax

Practice location:
  • Phone: 316-640-8823
  • Fax:
Mailing address:
  • Phone: 316-640-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MS. AMY ELIZABETH UNREIN
Title or Position: CLINICIAN/OWNER
Credential: LCSW
Phone: 316-640-8823