Healthcare Provider Details

I. General information

NPI: 1326490756
Provider Name (Legal Business Name): GRAND VALLEY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2016
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N 8TH ST UNIT B
GRAND JUNCTION CO
81501-3316
US

IV. Provider business mailing address

135 N 8TH ST UNIT B
GRAND JUNCTION CO
81501-3316
US

V. Phone/Fax

Practice location:
  • Phone: 970-623-7766
  • Fax: 970-549-3495
Mailing address:
  • Phone: 970-623-7766
  • Fax: 970-549-3495

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 Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHAWN DANIEL WILLIAMSON
Title or Position: OWNER
Credential: LPC
Phone: 970-812-3150