Healthcare Provider Details
I. General information
NPI: 1467037069
Provider Name (Legal Business Name): BRIGHTWOOD COUNSELING, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2307 MILLCREEK PL
HIGHLANDS RANCH CO
80126-4945
US
IV. Provider business mailing address
2307 MILLCREEK PL
HIGHLANDS RANCH CO
80126-4945
US
V. Phone/Fax
- Phone: 303-968-9308
- Fax:
- Phone: 303-968-9308
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
ANDREW
VALENTE
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 303-968-9308