Healthcare Provider Details

I. General information

NPI: 1730737479
Provider Name (Legal Business Name): NATASHA CALVILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 51ST AVE
GREELEY CO
80634-4225
US

IV. Provider business mailing address

309 51ST AVE
GREELEY CO
80634-4225
US

V. Phone/Fax

Practice location:
  • Phone: 303-989-8169
  • Fax:
Mailing address:
  • Phone: 970-324-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0023599
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: