Healthcare Provider Details

I. General information

NPI: 1346966686
Provider Name (Legal Business Name): GRAND VALLEY COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2478 PATTERSON RD STE 26
GRAND JUNCTION CO
81505-3606
US

IV. Provider business mailing address

1013 PRITCHARD MESA CT
GRAND JUNCTION CO
81505-9401
US

V. Phone/Fax

Practice location:
  • Phone: 575-642-7354
  • Fax:
Mailing address:
  • Phone: 575-642-7354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LINDA KEMP
Title or Position: DIRECTOR
Credential:
Phone: 575-642-7354