Healthcare Provider Details

I. General information

NPI: 1235748005
Provider Name (Legal Business Name): PAUL HASSEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6916 HIGHWAY 82
GLENWOOD SPRINGS CO
81601-9435
US

IV. Provider business mailing address

715 HORIZON DR STE 225
GRAND JUNCTION CO
81506-8743
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-2583
  • Fax:
Mailing address:
  • Phone: 970-683-7093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0006037
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: